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Holmes Tremor due to Artery of Percheron Infarct: Clinical Case and Treatment Using Deep Brain Stimulation of the Vim and ZI Targets

O'Shea, Sarah A.; Elkind, Mitchell S.; Pullman, Seth L.; Ford, Blair

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.

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Also Published In

Title
Tremor and Other Hyperkinetic Movements
DOI
https://doi.org/10.7916/tohm.v0.732

More About This Work

Academic Units
Center for Parkinson's Disease and Other Movement Disorders
Published Here
January 16, 2020