2019 Articles

Reversible Holmes Tremor due to Middle Cerebral Artery Giant Aneurysm

Poloni, Tino Emanuele; Galli, Alberto; Carlos, Arenn Faye; Riva, Emanuela; Medici, Valentina; Davin, Annalisa; Guaita, Antonio; Ceroni, Mauro

A 40-year-old man presented with a 6-month history of mild but worsening tremor of variable intensity. The patient had a focal, irregular, rest and action tremor of middle amplitude and low frequency (about 4 Hz), limited to his right arm with oscillatory motion around the elbow. It was present inconsistently at rest, particularly during emotional activation, and enhanced by posture maintenance. It was evoked by various positions and tasks. Particularly, the tremor was present during fine motor skills such as writing, and it was increased by drinking and shaving, showing a minimal intentional component. The patient also reported slight loss in manual dexterity in his right hand.