Ishimaru Tomoki, Nunomura Sumire, Wakita Masahiro, Ura Shigehisa
Department of Neurology, Asahikawa Red Cross Hospital.
Department of Neurology, Obihiro-Kosei General Hospital.
Rinsho Shinkeigaku. 2024 Apr 24;64(4):280-285. doi: 10.5692/clinicalneurol.cn-001913. Epub 2024 Mar 23.
A 75-year-old woman was referred to our department in October 2022 with ataxia and involuntary movements of the right upper and lower limbs. She had experienced a left pontine hemorrhage in March 2021, which was managed conservatively. However, she had residual right-sided hemiplegia. In addition, she had cerebellar ataxia and a 2 Hz resting tremor of the right upper and lower limbs, which was enhanced while maintaining posture and contemplation. Based on her history, and the findings of MRI and nuclear medicine imaging, we diagnosed the patient with Holmes tremor due to pontine hemorrhage. Holmes tremor is a rare movement disorder secondary to brainstem and thalamic lesions, characterized by a unilateral low-frequency tremor. In this case, I-IMP SPECT and MRI shows damage to the cerebellothalamic tract and dentaro-rubro-olivary pathway.
一名75岁女性于2022年10月因共济失调及右上肢和下肢不自主运动被转诊至我科。她在2021年3月发生过左侧脑桥出血，当时采取了保守治疗。然而，她仍遗留右侧偏瘫。此外，她还存在小脑性共济失调以及右上肢和下肢2Hz的静止性震颤，在保持姿势和思考时震颤加剧。根据她的病史、MRI及核医学影像检查结果，我们诊断该患者为脑桥出血所致的霍姆斯震颤。霍姆斯震颤是一种继发于脑干和丘脑病变的罕见运动障碍，其特征为单侧低频震颤。在本病例中，I-IMP SPECT和MRI显示小脑丘脑束及齿状核-红核-橄榄通路受损。
