Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 May;10(2):92-95.
doi: 10.14802/jmd.16051. Epub 2017 Apr 18.

Holmes' Tremor with Shoulder Pain Treated by Deep Brain Stimulation of Unilateral Ventral Intermediate Thalamic Nucleus and Globus Pallidus Internus

Sabri Aydın  1 , Huseyin Canaz  1 , Ezgi Tuna Erdogan  2 , Nazlı Durmaz  3 , Barıs Topcular  4
Affiliations

Holmes' Tremor with Shoulder Pain Treated by Deep Brain Stimulation of Unilateral Ventral Intermediate Thalamic Nucleus and Globus Pallidus Internus

Sabri Aydın et al. J Mov Disord. 2017 May.

Abstract

A 21-year-old male was admitted with severe right arm and hand tremors after a thalamic hemorrhage caused by a traffic accident. He was also suffering from agonizing pain in his right shoulder that manifested after the tremor. Neurologic examination revealed a disabling, severe, and irregular kinetic and postural tremor in the right arm during target-directed movements. There was also an irregular ipsilateral rest tremor and dystonic movements in the distal part of the right arm. The amplitude was moderate at rest and extremely high during kinetic and intentional movements. The patient underwent left globus pallidum internus and ventral intermediate thalamic nucleus deep brain stimulation. The patient improved by more than 80% as rated by the Fahn-Tolosa-Marin Tremor Rating Scale and Visual Analog Scale six months after surgery.

Keywords: Deep brain stimulation; Holmes’ tremor; globus pallidus internus; shoulder pain; ventralis intermedius nucleus.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest

The authors have no financial conflicts of interest.

Figures

Figure 1.
Figure 1.
Left thalamic hypointensity due to thalamic hemorrhage in axial T2-weighted sequence on MRI (A) and coronal T2-weighted sequence on MRI (B).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Aydin S, Abuzayed B, Kiziltan G, Gunduz A, Yagci S, Mengi M, et al. Unilateral thalamic Vim and GPi stimulation for the treatment of Holmes’ tremor caused by midbrain cavernoma: case report and review of the literature. J Neurol Surg A Cent Eur Neurosurg. 2013;74:271–276. - PubMed
    1. Deuschl G, Bergman H. Pathophysiology of nonparkinsonian tremors. Mov Disord. 2002;17 Suppl 3:S41–S48. - PubMed
    1. Lim DA, Khandhar SM, Heath S, Ostrem JL, Ringel N, Starr P. Multiple target deep brain stimulation for multiple sclerosis related and poststroke Holmes’ tremor. Stereotact Funct Neurosurg. 2007;85:144–149. - PubMed
    1. Espinoza Martinez JA, Arango GJ, Fonoff ET, Reithmeier T, Escobar OA, Furlanetti L, et al. Deep brain stimulation of the globus pallidus internus or ventralis intermedius nucleus of thalamus for Holmes tremor. Neurosurg Rev. 2015;38:753–763. - PubMed
    1. Krauss JK, Jankovic J. Head injury and posttraumatic movement disorders. Neurosurgery. 2002;50:927–939. discussion 939-940. - PubMed

LinkOut - more resources