Visualization of muscles involved in unilateral tremor using 13N-ammonia and positron emission tomography.

Using positron emission computerized tomography (PCT), a high uptake of IV injected 13N-ammonia was observed in the muscles of the right forearm and leg of a patient with a rightsided static tremor. In some muscles the concentration of 13NH3 was 8.5 times higher than in the symmetrical normal limb. Confrontation of the clinical, neurological, and electromyographic findings with the results of the PCT proved that the muscles with the high uptake corresponded to the muscles responsible for the tremulous movements. There is strong evidence that the high uptake of 13NH3 was related to the increased blood flow produced by the continuous rhythmic exercise of the muscles involved in the tremor. To our knowledge a similar observation has not been described before. It is suggested that the combined use of suitable positron emitters and PCT might provide a valuable tool for the noninvasive study of perfusion of individual skeletal muscles.