Holmes tremor

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First identified by Gordon Holmes in 1904, Holmes' tremor can be described as a flexion-extension oscillatory movement[1] but more specifically, flexion and extension of the fingers with rotation at the wrist and elbow.[2] Holmes' tremor is a combination of rest, action, and postural tremors. Tremor frequency ranges from 3 to 4 Hertz and is enhanced with posture and aggravated with movement.[1] It is a "wing-beating" type of tremor that is caused by cerebellar damage.[citation needed] It may arise from various underlying structural disorders including multiple sclerosis, stroke, tumors,cerebellar hemorrhage and ischemia, trauma, neuroleptics, neoplasm, radiation and rare cases of midbrain germinoma.[2] Tremor onset typically occurs 6 to 12 months after insult.[1]

So far, few studies on Holmes' tremor secondary to cavernoma have been reported.[3] Also, since Holmes’ tremor is rare, much of the research is based on individual cases.[2]

Treatments include pharmacotherapy such as levodopa, thalamotomy or chronic thalamic stimulation.[1] Levodopa is often not effective [1][2][4] but has helped in some cases.[2]


  1. ^ a b c d e Sheppard, Gordon M G; Erik Tauboll; Soren Jacob Bakke; Rolf Nyberg-Hansen (1997). "Midbrain Tremor and Hypertrophic Olivery Degeneration After Pontine Hemorrhage". Movement Disorders 12 (3): 432–437. doi:10.1002/mds.870120327. 
  2. ^ a b c d e Kim, M C; B C Son, Y Miyagi, J-K Kang (2002). "Vim thalamotomy for Holmes' tremor secondary to midbrain tumor". Journal of Neurology, Neurosurgery & Psychiatry 73: 453–455. doi:10.1136/jnnp.73.4.453. 
  3. ^ Leung GK, Fan YW, Ho SL. Rubral tremor associated with cavernous angioma of the midbrain. Mov Disord 1999; 14: 191-193. modified by Chinese Medical Jordan
  4. ^ Brittain, John-Stuart; Ned Jenkinson; Petter Holland; Raed A Joundi; Alex L Green; Tipu Aziz (2011). "Development of Holmes' tremor following hemi-cerebellar infarction". Movement Disorder 26 (10): 1957–1959. doi:10.1002/mds.23704.