Department of Neurology, Boston University School of Medicine, Boston University, Boston, MA, USA.
Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
Tremor Other Hyperkinet Mov (N Y). 2020 Jan 7;10. doi: 10.7916/tohm.v0.732. eCollection 2020.
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.
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.
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.
霍姆斯震颤（HT）源于小脑-丘脑-皮质通路的中断。病灶可以在任何部位中断投射，从而导致这种震颤。我们描述了一例因罕见的 Percheron 动脉梗死引起的 HT 病例及其使用深部脑刺激成功治疗的案例。
一名 62 岁女性，右侧大脑脚和双侧丘脑中风后出现 HT。进行了腹侧中间核（Vim）联合 ZI 的深部脑刺激（DBS）手术，震颤得到改善。
我们的病例支持这样一种理论，即更靠后的 ZI 靶点与 Vim 结合对治疗 DBS 反应不佳的震颤（如 HT）有益。
