Holmes´s Tremor as isolated or predominant manifestation in cerebellar lesions of vascular origin [Temblor de Holmes, como manifestación única o predominante en lesiones cerebelosas de origen vascular]
Autor
Vargas-Cañas A.
Nicolás Rebolledo V.
Resumen
Holmes`s tremor; or rubric tremor is infrequent as predominantly or unique manifestation of cerebellum stroke. Grosso modo tremor is a movement´s disorder common in medical practice, being the physiological exacerbated type the most frequently seen, and the essential tremor the most frequently seen in pathological involuntary movements. Neuroimaging studies have concluded the importance of the cerebellum and of the entire cortical-cerebellar- thalamic pathway in the pathogenesis of tremor in general; without specifically of all the structures involved; but among which is mentioned at the molecular level the Purkinje cells. Holmes`s tremor, is one of the frequently extrapyramidal manifestations of cerebellar lesions of vascular origin; and it is common to be associated with another symptomatology of posterior circulation. We present two cases of rubric Holmes tremor, as a predominant manifestation of stroke. The authors conclude that this type of presentation is possible, especially in patients with Holmes tremor with ictal onset, or in those cases of non-parkinsonian resting tremor that responds poorly to L-Dopa; and suggest that in such cases, with non-mesencephalic injury, patients could benefit from the use of anticholinergics. © 2019 Sociedad de Neurologia Psiquiatria y Neurocirugia. All rights reserved.
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