Nakamura R, Kamakura K, Tadano Y, Hosoda Y, Nagata N, Tsuchiya K, Iwata M, Shibasaki H
Third Department of Internal Medicine, National Defense Medical College, Saitama, Japan.
Mov Disord. 1993 Apr;8(2):209-12. doi: 10.1002/mds.870080218.
Two cases with severe tremors were studied by means of electromyograms using surface electrodes and also by magnetic resonance (MR) imaging. The first case was associated with multiple sclerosis and demonstrated a severe postural cerebellar tremor and an alternate activation of antagonist muscles in the right arm. The second case, with hemorrhage in the brainstem, demonstrated a severe tremor at rest and mixed synchronous and alternating activation of antagonist muscles in the left forearm. MR imaging studies localized lesions possibly responsible for these tremors. In the first case a lesion was located in the superior cerebellar peduncle just under the decussation, and in the second case a lesion was found between the red nucleus and the thalamus, with possible involvement of both the cerebellothalamic and nigrostriatal pathways. The first case accords with the theory that a lesion located in the dentate nucleus and its projection can cause severe postural cerebellar tremor. The lesion demonstrated in the second case may be responsible for "cerebellar tremor at rest" or "static (resting) cerebellar tremor."
通过使用表面电极的肌电图以及磁共振成像对两例严重震颤患者进行了研究。第一例与多发性硬化症相关，表现为严重的姿势性小脑震颤以及右臂拮抗肌的交替激活。第二例患者脑干出血，表现为静止时严重震颤以及左前臂拮抗肌的混合性同步和交替激活。磁共振成像研究确定了可能导致这些震颤的病变部位。第一例中，病变位于交叉下方的小脑上脚；第二例中，病变位于红核和丘脑之间，可能累及小脑丘脑和黑质纹状体通路。第一例符合齿状核及其投射部位的病变可导致严重姿势性小脑震颤的理论。第二例中显示的病变可能是“静止性小脑震颤”或“静态（静止时）小脑震颤”的病因。
