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Original Article
Analysis of Semiology, Lesion Topography and Treatment Outcomes: A Prospective Study on Post Thalamic Stroke Holmes Tremor
Amlan Kusum Datta, Adreesh Mukherjee, Sudeshna Malakar, Atanu Biswas
J Mov Disord. 2024;17(1):71-81.   Published online October 20, 2023
DOI: https://doi.org/10.14802/jmd.23095
  • 671 View
  • 72 Download
AbstractAbstract PDFSupplementary Material
Objective
Holmes tremor (HT) comprises rest, postural and intention tremor subtypes, usually involving both proximal and distal musculature. Perturbations of nigro-striatal pathways might be fundamental in the pathogenesis of HT along with cerebello-thalamic connections.
Methods
Nine patients with an HT phenotype secondary to thalamic stroke were included. Epidemiological and clinical records were obtained. Structural and functional brain imaging were performed with magnetic resonance imaging (MRI) or computed tomography (CT) and positron emission tomography (PET), respectively. Levodopa was administered in sequentially increasing dosage, with various other drugs in case of inadequate response. Longitudinal follow-up was performed for at least three months. The essential tremor rating assessment scale (TETRAS) was used for assessment.
Results
The mean latency from stroke to tremor onset was 50.4 ± 30.60 days (range 21–90 days). Dystonia was the most frequently associated hyperkinetic movement (88.8%). Tremor was bilateral in 22.2% of participants. Clinical response was judged based on a reduction in the TETRAS score by a prefixed value (≥ 30%), pertaining to which 55.5% (n = 5) of subjects were classified as responders and the rest as non-responders. The responders showed improvement with significantly lower doses of levodopa than the remaining nonresponders (240 ± 54.7 mg vs. 400 ± 40.8 mg; p = 0.012).
Conclusion
Although levodopa is useful in HT, augmenting the dosage of levodopa beyond a certain point might not benefit patients clinically. Topography of vascular lesions within the thalamus might additionally influence the phenomenology of HT.
Case Report
Treatment of Hemichoreoathetosis with Arrhythmic Proximal Tremor after Stroke: The Role of Zona Incerta as a Target for Deep Brain Stimulation
Andrei Koerbel, Augusto Radünz do Amaral, Helena Bedatti Zeh, Eduardo Wollmann, Renata Fabiola Heil Koerbel, Carla Moro, Alexandre Luiz Longo
J Mov Disord. 2019;12(1):47-51.   Published online January 30, 2019
DOI: https://doi.org/10.14802/jmd.18032
  • 6,753 View
  • 111 Download
  • 3 Web of Science
  • 3 Crossref
AbstractAbstract PDFSupplementary Material
Deep brain stimulation (DBS) of the zona incerta has shown promising results in the reduction of medically refractory movement disorders. However, evidence supporting its efficacy in movement disorders secondary to hemorrhagic stroke or hemichoreoathetosis is limited. We describe a 48-year-old man who developed progressive hemichoreoathetosis with an arrhythmic, proximal tremor in his right arm following a thalamic hemorrhagic stroke. Pharmacological treatment was carried out with no change in the Abnormal Involuntary Movement Scale (AIMS) score after 4 weeks (14). After six sessions of botulinum toxin treatment, a subtle improvement in the AIMS score (13) was registered, but no clinical improvement was noted. The arrhythmic proximal movements were significantly improved after DBS of the zona incerta with a major decrease in the patient’s AIMS score (8). The response to DBS occurring after the failure of pharmacological and botulinum toxin treatments suggests that zona incerta DBS may be an alternative for postthalamic hemorrhage movement disorders.

Citations

Citations to this article as recorded by  
  • Deep brain stimulation for movement disorders after stroke: a systematic review of the literature
    Mitch R. Paro, Michal Dyrda, Srinath Ramanan, Grant Wadman, Stacey-Ann Burke, Isabella Cipollone, Cory Bosworth, Sarah Zurek, Patrick B. Senatus
    Journal of Neurosurgery.2022; : 1.     CrossRef
  • Deep brain stimulation for post-thalamic stroke complex movement disorders
    A. Macerollo, B. Hammersley, M. Bonello, J. Somerset, D. Bhargava, K. Das, J. Osman-Farah, P. R. Eldridge, S. H. Alusi
    Neurological Sciences.2021; 42(1): 337.     CrossRef
  • Neurologic Manifestations of Systemic Disease: Movement Disorders
    Giulietta M. Riboldi, Steven J. Frucht
    Current Treatment Options in Neurology.2021;[Epub]     CrossRef
Review Articles
Movement Disorders Following Cerebrovascular Lesions: Etiology, Treatment Options and Prognosis
Do-Young Kwon
J Mov Disord. 2016;9(2):63-70.   Published online May 25, 2016
DOI: https://doi.org/10.14802/jmd.16008
  • 21,594 View
  • 677 Download
  • 8 Web of Science
  • 11 Crossref
AbstractAbstract PDF
Post-stroke movement disorders are uncommon, but comprise an important part of secondary movement disorders. These exert variable and heterogeneous clinical courses according to the stroke lesion and its temporal relationships. Moreover, the predominant stroke symptoms hinder a proper diagnosis in clinical practice. This article describes the etiology, treatment options and prognosis of post-stroke movement disorders.

Citations

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  • Post-stroke movement disorders disappearance: a report of disappearance of tardive dyskinesia after stroke and a literature review
    Min Seung Kim, InJa Shin, Don Gueu Park, Jung han Yoon
    Acta Neurologica Belgica.2023; 123(5): 2005.     CrossRef
  • Monochorea after acute contralateral pontine infarction: A case report
    Yun Su Hwang, Byoung-Soo Shin, Han Uk Ryu, Hyun Goo Kang
    Medicine.2023; 102(3): e32660.     CrossRef
  • Adult-onset sporadic chorea: real-world data from a single-centre retrospective study
    Roberta Bovenzi, Matteo Conti, Rocco Cerroni, Mariangela Pierantozzi, Alessandro Stefani, Antonio Pisani, Nicola Biagio Mercuri, Tommaso Schirinzi
    Neurological Sciences.2022; 43(1): 387.     CrossRef
  • Parkinsonism and ataxia
    Giulia Franco, Giulia Lazzeri, Alessio Di Fonzo
    Journal of the Neurological Sciences.2022; 433: 120020.     CrossRef
  • Movement Disorders Associated With Cerebral Artery Stenosis: A Nationwide Study
    Kye Won Park, Nari Choi, Eungseok Oh, Chul Hyoung Lyoo, Min Seok Baek, Han-Joon Kim, Dalla Yoo, Jee-Young Lee, Ji-Hyun Choi, Jae Hyeok Lee, Seong-Beom Koh, Young Hee Sung, Jin Whan Cho, Hui-Jun Yang, Jinse Park, Hae-Won Shin, Tae-Beom Ahn, Ho-Sung Ryu, So
    Frontiers in Neurology.2022;[Epub]     CrossRef
  • Post-stroke Movement Disorders: Clinical Spectrum, Pathogenesis, and Management
    Priyanka Tater, Sanjay Pandey
    Neurology India.2021; 69(2): 272.     CrossRef
  • Hemibalismo y hemicorea secundarios a un ataque cerebrovascular isquémico insular, una presentación inusual: reporte de caso
    Carlos Martínez-Rubio, Hellen Kreinter-Rosenbaum, Habib Moutran-Barroso
    Neurología Argentina.2020; 12(3): 207.     CrossRef
  • Hemiballismus in subcortical lacunar infarcts
    ChinyeluUchenna Ufoaroh, OvercomerNnaemeka Agah, Nnamdi Morah, ErnestNdukaife Anyabolu
    Nigerian Journal of Medicine.2020; 29(3): 527.     CrossRef
  • COVID-19 and stroke: Red flags for secondary movement disorders?
    Daniella Balduino Victorino, Marcia Guimarães-Marques, Mariana Nejm, Fulvio Alexandre Scorza, Carla Alessandra Scorza
    eNeurologicalSci.2020; 21: 100289.     CrossRef
  • Post-stroke restless arm syndrome mimicking hemichorea–hemiballism
    Ha-yom Kim, Moon-Ho Park, Do-Young Kwon
    Acta Neurologica Belgica.2017; 117(3): 791.     CrossRef
  • Vascular Pathology Causing Late Onset Generalized Chorea: A Clinico‐Pathological Case Report
    Paula Salgado, Ricardo Taipa, Joana Domingos, Daniel Dias, Manuel Melo Pires, Marina Magalhães
    Movement Disorders Clinical Practice.2017; 4(6): 819.     CrossRef
Movement Disorders Following Cerebrovascular Lesions in Cerebellar Circuits
Seong-Min Choi
J Mov Disord. 2016;9(2):80-88.   Published online May 25, 2016
DOI: https://doi.org/10.14802/jmd.16004
  • 20,850 View
  • 495 Download
  • 27 Web of Science
  • 22 Crossref
AbstractAbstract PDF
Cerebellar circuitry is important to controlling and modifying motor activity. It conducts the coordination and correction of errors in muscle contractions during active movements. Therefore, cerebrovascular lesions of the cerebellum or its pathways can cause diverse movement disorders, such as action tremor, Holmes’ tremor, palatal tremor, asterixis, and dystonia. The pathophysiology of abnormal movements after stroke remains poorly understood. However, due to the current advances in functional neuroimaging, it has recently been described as changes in functional brain networks. This review describes the clinical features and pathophysiological mechanisms in different types of movement disorders following cerebrovascular lesions in the cerebellar circuits.

Citations

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  • Genome-wide association study of cerebellar white matter microstructure and genetic overlap with common brain disorders
    Bang-Sheng Wu, Yi-Jun Ge, Wei Zhang, Shi-Dong Chen, Shi-Tong Xiang, Ya-Ru Zhang, Ya-Nan Ou, Yu-Chao Jiang, Lan Tan, Wei Cheng, John Suckling, Jian-Feng Feng, Jin-Tai Yu, Ying Mao
    NeuroImage.2023; 269: 119928.     CrossRef
  • Deep Brain Stimulation for Holmes Tremors and Literature Review
    Kunkala Lavanya, P. Vijaya Shankar, K. Visvanathan, S. Sundar, P. Philohazeena
    Annals of Indian Academy of Neurology.2023; 26(3): 296.     CrossRef
  • The Guillain-Mollaret triangle: a key player in motor coordination and control with implications for neurological disorders
    Eren Ogut, Kutay Armagan, Doruktan Tufekci
    Neurosurgical Review.2023;[Epub]     CrossRef
  • Clinical study of six patients with pure dysarthria and dysarthria—(Central) facial nerve palsy/isolated central facial nerve palsy caused by extracerebellar infarction
    Katsuhiko Ogawa, Takayoshi Akimoto, Makoto Hara, Midori Fujishiro, Hideto Nakajima
    Neurology and Clinical Neuroscience.2023;[Epub]     CrossRef
  • Morphological and Functional Principles Governing the Plasticity Reserve in the Cerebellum: The Cortico-Deep Cerebellar Nuclei Loop Model
    Hiroshi Mitoma, Shinji Kakei, Hirokazu Tanaka, Mario Manto
    Biology.2023; 12(11): 1435.     CrossRef
  • Holmes tremor: an updated review
    Efstratios-Stylianos Pyrgelis, Eleni Agapiou, Efthalia Angelopoulou
    Neurological Sciences.2022; 43(12): 6731.     CrossRef
  • Post-stroke Movement Disorders: Clinical Spectrum, Pathogenesis, and Management
    Priyanka Tater, Sanjay Pandey
    Neurology India.2021; 69(2): 272.     CrossRef
  • Delayed cervicobrachial segmental dystonia secondary to ipsilateral cerebellar infarction
    VikramV Holla, SudhakarPushpa Chaithra, Shweta Prasad, PramodKumar Pal
    Annals of Movement Disorders.2021;[Epub]     CrossRef
  • Pathophysiology of Cerebellar Tremor: The Forward Model-Related Tremor and the Inferior Olive Oscillation-Related Tremor
    Shinji Kakei, Mario Manto, Hirokazu Tanaka, Hiroshi Mitoma
    Frontiers in Neurology.2021;[Epub]     CrossRef
  • Case Report: Dual Target Deep Brain Stimulation With Externalized Programming for Post-traumatic Complex Movement Disorder
    Ron Gadot, Ben Shofty, Ricardo A. Najera, Adrish Anand, Garrett Banks, Abdul Basit Khan, Melissa A. LoPresti, Nora Vanegas Arroyave, Sameer A. Sheth
    Frontiers in Neuroscience.2021;[Epub]     CrossRef
  • Gadolinium-based contrast agents – what is the evidence for ‘gadolinium deposition disease’ and the use of chelation therapy?
    Kerry A. Layne, David M. Wood, Paul I. Dargan
    Clinical Toxicology.2020; 58(3): 151.     CrossRef
  • POLR3A variants with striatal involvement and extrapyramidal movement disorder
    Inga Harting, Murtadha Al-Saady, Ingeborg Krägeloh-Mann, Annette Bley, Maja Hempel, Tatjana Bierhals, Stephanie Karch, Ute Moog, Geneviève Bernard, Richard Huntsman, Rosalina M. L. van Spaendonk, Maaike Vreeburg, Agustí Rodríguez-Palmero, Aurora Pujol, Ma
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  • Ataxic hemiparesis after corona radiata infarct: Diffusion tensor imaging correlation of corticoponto-cerebellar tract injury
    Jun Young Kim, Jeong Pyo Seo, Min Cheol Chang
    Translational Neuroscience.2020; 11(1): 1.     CrossRef
  • The Rehapiano—Detecting, Measuring, and Analyzing Action Tremor Using Strain Gauges
    Norbert Ferenčík, Miroslav Jaščur, Marek Bundzel, Filippo Cavallo
    Sensors.2020; 20(3): 663.     CrossRef
  • Oxygen Cost During Walking in Individuals With Stroke: Hemiparesis Versus Cerebellar Ataxia
    Maxence Compagnat, Jean-Christophe Daviet, Charles Batcho, Nicolas Vuillerme, Jean-Yves Salle, Romain David, Stephane Mandigout
    Neurorehabilitation and Neural Repair.2020; 34(4): 289.     CrossRef
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    Katherine Ellis, Chris Oliver, Chrysi Stefanidou, Ian Apperly, Jo Moss
    Journal of Autism and Developmental Disorders.2020; 50(11): 4001.     CrossRef
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    Min Cheol Chang, Jeong Pyo Seo
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  • KCND3-Related Neurological Disorders: From Old to Emerging Clinical Phenotypes
    Luca Pollini, Serena Galosi, Manuela Tolve, Caterina Caputi, Carla Carducci, Antonio Angeloni, Vincenzo Leuzzi
    International Journal of Molecular Sciences.2020; 21(16): 5802.     CrossRef
  • Posterior Subthalamic Area Deep Brain Stimulation for Treatment of Refractory Holmes Tremor
    Malgorzata Dec-Ćwiek, Marcin Tutaj, Wojciech Pietraszko, Witold Libionka, Mariusz Krupa, Marek Moskała, Monika Rudzińska-Bar, Agnieszka Słowik, Joanna Pera
    Stereotactic and Functional Neurosurgery.2019; 97(3): 183.     CrossRef
  • Teaching Video NeuroImages: A patient with Holmes tremor due to demyelinating lesion of the inferior cerebellar peduncle
    Daniel G. Di Luca, Andres De Leon-Benedetti, Stacey Williamson, Le Treice Irving, Jason Margolesky
    Neurology.2019;[Epub]     CrossRef
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  • Rubral Tremor Associated with Klinefelter Syndrome; a Case Report and Literature Review
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Case Reports
Restlessness with Manic Episodes due to Right Parietal Infarction
Suk Yun Kang, Jong Won Paik, Young Ho Sohn
J Mov Disord. 2010;3(1):22-24.
DOI: https://doi.org/10.14802/jmd.10007
  • 14,795 View
  • 92 Download
  • 4 Crossref
AbstractAbstract PDF

Mood disorders following acute stroke are relatively common. However, restlessness with manic episodes has rarely been reported. Lesions responsible for post-stroke mania can be located in the thalamus, caudate nucleus, and temporal and frontal lobes. We present a patient who exhibited restlessness with manic episodes after an acute infarction in the right parietal lobe, and summarize the case reports involving post-stroke mania. The right parietal stroke causing mania in our case is a novel observation that may help us to understand the mechanisms underlying restlessness with mania following acute stroke.

Citations

Citations to this article as recorded by  
  • Restlessness with manic episodes induced by right-sided multiple strokes after COVID-19 infection: A case report
    Takahiko Nagamine
    Brain Circulation.2023; 9(2): 112.     CrossRef
  • Poststroke Mania During the COVID-19 Pandemic
    Takahiko Nagamine
    Journal of Nervous & Mental Disease.2023; 211(12): 979.     CrossRef
  • Management of psychiatric disorders in patients with stroke and traumatic brain injury
    Gautam Saha, Kaustav Chakraborty, Amrit Pattojoshi
    Indian Journal of Psychiatry.2022; 64(8): 344.     CrossRef
  • Post stroke delirium
    M. A. Savina
    Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova.2014; 114(12. Vyp. 2): 19.     CrossRef
Painless Legs and Moving Toes as an Initial Presentation of Ischemic Stroke
Se Mi Oh, Won Tae Yoon, Ji Youn Kim, Hee-Young Shin, Won Yong Lee
J Mov Disord. 2009;2(1):40-42.
DOI: https://doi.org/10.14802/jmd.09010
  • 39,417 View
  • 97 Download
  • 3 Crossref
AbstractAbstract PDF

Painless legs and moving toes is an unusual syndrome, which has not previously been reported as an initial presentation of ischemic stroke. We encountered a 78-year-old woman who developed dysarthria and involuntary movement of her left toes that was clinically regarded as painless legs and moving toes. These symptoms appeared abruptly and simultaneously as the initial symptoms of stroke, and improved gradually with conservative management by intravenous hydration for a month. We suggest that, in our case, a cortical brain lesion caused by ischemic stroke might be associated with the development of painless legs and moving toes.

Citations

Citations to this article as recorded by  
  • Painful legs and moving toes syndrome
    Hiroki Tamura, Kosuke Ishizuka, Kiyoshi Shikino, Masatomi Ikusaka
    BMJ Case Reports.2021; 14(3): e240692.     CrossRef
  • Movement Disorders Following Cerebrovascular Lesions: Etiology, Treatment Options and Prognosis
    Do-Young Kwon
    Journal of Movement Disorders.2016; 9(2): 63.     CrossRef
  • Painful legs and moving toes syndrome in a 16-year-old girl
    Seung Soo Kim, Yong Seung Hwang, Young Chang Kim
    Korean Journal of Pediatrics.2016; 59(9): 381.     CrossRef

JMD : Journal of Movement Disorders