J Mov Disord.  2017 May;10(2):92-95. 10.14802/jmd.16051.

Holmes' Tremor with Shoulder Pain Treated by Deep Brain Stimulation of Unilateral Ventral Intermediate Thalamic Nucleus and Globus Pallidus Internus

• Aydın S
• Canaz H
• Erdogan ET
• Durmaz N
• Topcular B

• KMID: 2379642
• DOI: http://doi.org/10.14802/jmd.16051

Abstract

A 21-year-old male was admitted with severe right arm and hand tremors after a thalamic hemorrhage caused by a traffic accident. He was also suffering from agonizing pain in his right shoulder that manifested after the tremor. Neurologic examination revealed a disabling, severe, and irregular kinetic and postural tremor in the right arm during target-directed movements. There was also an irregular ipsilateral rest tremor and dystonic movements in the distal part of the right arm. The amplitude was moderate at rest and extremely high during kinetic and intentional movements. The patient underwent left globus pallidum internus and ventral intermediate thalamic nucleus deep brain stimulation. The patient improved by more than 80% as rated by the Fahn-Tolosa-Marin Tremor Rating Scale and Visual Analog Scale six months after surgery.

Keyword

Deep brain stimulation; globus pallidus internus; Holmes' tremor; shoulder pain; ventralis intermedius nucleus

MeSH Terms

Accidents, Traffic
Arm
Deep Brain Stimulation*
Felodipine
Globus Pallidus*
Hand
Hemorrhage
Humans
Male
Neurologic Examination
Shoulder Pain*
Shoulder*
Tremor*
Visual Analog Scale
Young Adult
Felodipine