Vim thalamotomy in a patient with Holmes' tremor and palatal tremor - Pathophysiological considerations. 2015

Futaba Maki, and Sumito Sato, and Katsushige Watanabe, and Toshiyuki Yanagisawa, and Yuta Hagiwara, and Takahiro Shimizu, and Yasuhiro Hasegawa
Department of Neurology, St. Marianna University School of Medicine, Kawasaki, Kanagawa, 216-8511, Japan. f2maki@marianna-u.ac.jp.

BACKGROUND We peformed a ventral intermediate nucleus (Vim) thalamotomy in a patient with Holmes' tremor and palatal tremor. The frequencies of these movement disorders were 4 Hz and 3 Hz, respectively. Vim thalamotomy stopped the Holmes' tremor but not the palatal tremor. Our observations suggest different mechanisms for these two involuntary movements. METHODS A 57-arm 11 months after a pontine hemorrhage. Transoral carotid ultrasonography revealed periodic motion of her posterior pharyngeal wall with a frequency of 3 Hz. Recording of neuronal activities in the thalamus revealed a 4Hz rhythmic discharge time that was associated with her tremor in the contralateral arm. A left Vim thalamotomy was performed. The resting tremor of the upper limb stopped, but the kinetic tremor recurred 6 months after the thalamotomy. No effect was observed on her palatal tremor. CONCLUSIONS The different effects of Vim thalamotomy on the Holmes' tremor and palatal tremor suggest different oscillation sources for these two involuntary movements.

UI MeSH Term Description Entries
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009434 Neural Pathways Neural tracts connecting one part of the nervous system with another. Neural Interconnections,Interconnection, Neural,Interconnections, Neural,Neural Interconnection,Neural Pathway,Pathway, Neural,Pathways, Neural
D009847 Olivary Nucleus A brainstem nuclear complex. in the hindbrain, also referred to as the olivary body. The olivary nuclear complex is a part of the MEDULLA OBLONGATA and the PONTINE TEGMENTUM. It is involved with motor control and is a major source of sensory input to the CEREBELLUM. Basal Nucleus, Olivary,Nucleus Basalis, Olivary,Olivary Body,Olivary Complex,Olivary Nuclei,Complex, Olivary,Nucleus, Olivary,Nucleus, Olivary Basal,Olivary Basal Nucleus,Olivary Bodies
D010156 Palatal Muscles The muscles of the palate are the glossopalatine, palatoglossus, levator palati(ni), musculus uvulae, palatopharyngeus, and tensor palati(ni). Muscle, Palatal,Muscles, Palatal,Palatal Muscle
D010507 Periodicity The tendency of a phenomenon to recur at regular intervals; in biological systems, the recurrence of certain activities (including hormonal, cellular, neural) may be annual, seasonal, monthly, daily, or more frequently (ultradian). Cyclicity,Rhythmicity,Biological Rhythms,Bioperiodicity,Biorhythms,Biological Rhythm,Bioperiodicities,Biorhythm,Cyclicities,Periodicities,Rhythm, Biological,Rhythmicities,Rhythms, Biological
D010609 Pharyngeal Muscles The muscles of the PHARYNX are voluntary muscles arranged in two layers. The external circular layer consists of three constrictors (superior, middle, and inferior). The internal longitudinal layer consists of the palatopharyngeus, the salpingopharyngeus, and the stylopharyngeus. During swallowing, the outer layer constricts the pharyngeal wall and the inner layer elevates pharynx and LARYNX. Palatopharyngeus,Muscles of Pharynx,Palatopharyngeal Muscle,Salpingopharyngeus,Stylopharyngeus,Velopharyngeal Muscle,Muscle, Palatopharyngeal,Muscle, Pharyngeal,Muscle, Velopharyngeal,Muscles, Pharyngeal,Pharyngeal Muscle,Pharynx Muscle,Pharynx Muscles
D002543 Cerebral Hemorrhage Bleeding into one or both CEREBRAL HEMISPHERES including the BASAL GANGLIA and the CEREBRAL CORTEX. It is often associated with HYPERTENSION and CRANIOCEREBRAL TRAUMA. Brain Hemorrhage, Cerebral,Cerebral Parenchymal Hemorrhage,Hemorrhage, Cerebral,Intracerebral Hemorrhage,Hemorrhage, Cerebrum,Brain Hemorrhages, Cerebral,Cerebral Brain Hemorrhage,Cerebral Brain Hemorrhages,Cerebral Hemorrhages,Cerebral Parenchymal Hemorrhages,Cerebrum Hemorrhage,Cerebrum Hemorrhages,Hemorrhage, Cerebral Brain,Hemorrhage, Cerebral Parenchymal,Hemorrhage, Intracerebral,Hemorrhages, Cerebral,Hemorrhages, Cerebral Brain,Hemorrhages, Cerebral Parenchymal,Hemorrhages, Cerebrum,Hemorrhages, Intracerebral,Intracerebral Hemorrhages,Parenchymal Hemorrhage, Cerebral,Parenchymal Hemorrhages, Cerebral
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014202 Tremor Cyclical movement of a body part that can represent either a physiologic process or a manifestation of disease. Intention or action tremor, a common manifestation of CEREBELLAR DISEASES, is aggravated by movement. In contrast, resting tremor is maximal when there is no attempt at voluntary movement, and occurs as a relatively frequent manifestation of PARKINSON DISEASE. Action Tremor,Intention Tremor,Resting Tremor,Coarse Tremor,Continuous Tremor,Darkness Tremor,Fine Tremor,Intermittent Tremor,Involuntary Quiver,Massive Tremor,Passive Tremor,Persistent Tremor,Pill Rolling Tremor,Rest Tremor,Saturnine Tremor,Senile Tremor,Static Tremor,Tremor, Limb,Tremor, Muscle,Tremor, Neonatal,Tremor, Nerve,Tremor, Perioral,Tremor, Semirhythmic,Action Tremors,Coarse Tremors,Continuous Tremors,Darkness Tremors,Fine Tremors,Intention Tremors,Intermittent Tremors,Involuntary Quivers,Limb Tremor,Limb Tremors,Massive Tremors,Muscle Tremor,Muscle Tremors,Neonatal Tremor,Neonatal Tremors,Nerve Tremor,Nerve Tremors,Passive Tremors,Perioral Tremor,Perioral Tremors,Persistent Tremors,Pill Rolling Tremors,Quiver, Involuntary,Rest Tremors,Resting Tremors,Saturnine Tremors,Semirhythmic Tremor,Semirhythmic Tremors,Senile Tremors,Static Tremors,Tremor, Action,Tremor, Coarse,Tremor, Continuous,Tremor, Darkness,Tremor, Fine,Tremor, Intention,Tremor, Intermittent,Tremor, Massive,Tremor, Passive,Tremor, Persistent,Tremor, Pill Rolling,Tremor, Rest,Tremor, Resting,Tremor, Saturnine,Tremor, Senile,Tremor, Static,Tremors

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