Holmes Tremor due to Artery of Percheron Infarct: Clinical Case and Treatment Using Deep Brain Stimulation of the Vim and ZI Targets. (7th January 2020)

• Record Type: Journal Article
• Authors: O'Shea, Sarah A.; Elkind, Mitchell; Pullman, Seth L.; Ford, Blair
• Is Part Of: Tremor and other hyperkinetic movements. Volume 10(2020)
• Publication Date: 2020-01-07
• Subjects: Deep brain stimulation -- Holmes tremor -- tremor -- neurostimulation; Tremor -- Periodicals; Hyperkinesia -- Periodicals; 616.8
• DOI: 10.7916/tohm.v0.732
• Languages: English
• ISSNs: 2160-8288

Abstract

Background: Holmes tremor (HT) arises from disruption of the cerebellothalamocortical pathways. A lesion can interrupt the projection at any point, resulting in this tremor. We describe a case of HT due to the rare artery of Percheron infarct and its successful treatment using deep brain stimulation. Case report: A 62-year-old woman with a right medial cerebral peduncle and bilateral thalamic stroke developed HT. Ventral intermediate nucleus (Vim) zona incerta (ZI) deep brain stimulation (DBS) surgery was performed, with improvement in her tremor. Discussion: Our case supports the theory that the more caudal ZI target in combination with Vim is beneficial in treating poorly DBS-responsive tremors such as HT.