Vidailhet M, Jedynak C P, Pollak P, Agid Y
INSERM U289, Hôpital de la Salpêtrière, Paris, France.
Mov Disord. 1998;13 Suppl 3:49-54. doi: 10.1002/mds.870131309.
Symptomatic tremors are labeled in the literature under different names including rubral tremor, midbrain tremor, thalamic tremor, myorhythmia, Holmes' tremor, cerebellar tremor, and goal-directed tremor. The most common tremor is a delayed-onset postural and action tremor with a low frequency of 3 Hz and a proximal distribution. Resting irregular tremor is sometimes present. Mild cerebellar dysmetria is often detected. The lesions are mainly located in the thalamus, the brain stem, and the cerebellum, with secondary interruption and degeneration of various pathways and olivary hypertrophy. The more consistent lesions are found in the cerebello-thalamo-cortical and dentato-rubro-olivary pathways. The role of superimposed dysfunction of the nigrostriatal system may account for the rest component. The role of the basal ganglia in the emergence and control of tremor is poorly understood.
有症状的震颤在文献中有不同的命名，包括红核震颤、中脑震颤、丘脑震颤、肌节律失调、霍姆斯震颤、小脑震颤和目标导向性震颤。最常见的震颤是迟发性姿势性和动作性震颤，频率低，为3赫兹，且分布于近端。有时会出现静止性不规则震颤。常检测到轻度小脑辨距不良。病变主要位于丘脑、脑干和小脑，伴有各种通路的继发性中断和变性以及橄榄体肥大。在小脑 - 丘脑 - 皮质和齿状核 - 红核 - 橄榄体通路中发现了更一致的病变。黑质纹状体系统叠加功能障碍的作用可能解释了静止成分。基底神经节在震颤的发生和控制中的作用尚不清楚。
