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First identified by Gordon Holmes in 1904, Holmes' tremor can be described as a flexion-extension oscillatory movement but more specifically, flexion and extension of the fingers with rotation at the wrist and elbow.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. It is a "wing-beating" type of tremor that is caused by cerebellar damage. 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. Tremor onset typically occurs 6 to 12 months after insult.
So far, few studies on Holmes' tremor secondary to cavernoma have been reported. Also, since Holmes’ tremor is rare, much of the research is based on individual cases.
Treatments include pharmacotherapy such as levodopa, thalamotomy or chronic thalamic stimulation. Levodopa is often not effective  but has helped in some cases.
^ abcdeSheppard, Gordon M G; Erik Tauboll; Soren Jacob Bakke; Rolf Nyberg-Hansen (1997). "Midbrain Tremor and Hypertrophic Olivery Degeneration After Pontine Hemorrhage". Movement Disorders12 (3): 432–437. doi:10.1002/mds.870120327.
^ abcdeKim, M C; B C Son, Y Miyagi, J-K Kang (2002). "Vim thalamotomy for Holmes' tremor secondary to midbrain tumor". Journal of Neurology, Neurosurgery & Psychiatry73: 453–455. doi:10.1136/jnnp.73.4.453.Cite uses deprecated parameters (help)
^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
^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 Disorder26 (10): 1957–1959. doi:10.1002/mds.23704.
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