Dove C A, Vezzetti D, Escobar N
Loyola University Medical Center/Hines VA/Marianjoy Rehabilitation Center, Maywood, IL.
Arch Phys Med Rehabil. 1994 Sep;75(9):1011-4.
Tremor has been rarely described as a manifestation of stroke. A 21-year-old left-handed man developed severe action tremor of his distal left upper extremity and hand following a right parieto-occipital intracerebral hemorrhage. Strength of the left upper extremity improved gradually during a 3-month period but a severe action tremor developed. The patient was treated with the cardioselective beta-blocking agent, metoprolol, initially for elevated blood pressure and tachycardia at 25 mg twice daily for approximately 2 months. Metoprolol was then increased at weekly intervals by 25mg twice daily to a total of 100mg twice daily. Tremor intensity decreased clinically and graphically as monitored by a trace test by having the patient attempt to trace a horizontal and vertical axis and scoring the errors. The scores declined weekly from the first week (4,347), second week (3,786), third week (1,088), to the fourth week (484). No adverse cognitive or cardiopulmonary effects were noted. Action tremor should be considered as one of the movement disorders caused by hemorrhagic cerebral infarction. This case responded well to treatment with metoprolol.
震颤很少被描述为中风的一种表现。一名21岁的左撇子男性在右侧顶枕部脑出血后，左侧上肢远端和手部出现严重的动作性震颤。在3个月的时间里，左侧上肢力量逐渐改善，但出现了严重的动作性震颤。患者最初因血压升高和心动过速接受心脏选择性β受体阻滞剂美托洛尔治疗，每日两次，每次25毫克，持续约2个月。随后美托洛尔每周增加剂量，每日两次，每次增加25毫克，直至每日两次，每次100毫克。通过让患者尝试描绘水平和垂直轴并对误差进行评分的轨迹测试监测，震颤强度在临床和图形上均有所下降。评分从第一周（4347）、第二周（3786）、第三周（1088）到第四周（484）每周下降。未观察到不良认知或心肺效应。动作性震颤应被视为出血性脑梗死引起的运动障碍之一。该病例对美托洛尔治疗反应良好。
