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Neurological Sciences

, Volume 36, Issue 7, pp 1281–1283 | Cite as

Surface electromyography analysis of contralateral lower extremity tremor following thalamic hemorrhage

  • Yu Jin Jung
  • Jin San Lee
  • Won Chul ShinEmail author
Letter to the Editor

Although there are various movement disorders that can develop after thalamic stroke, isolated tremors confined to the lower extremities are rare, and their pathophysiological mechanism is unclear [1]. Here, we present a case of delayed-onset, regular, transient tremor following thalamic hemorrhage, which we confirm using surface electromyography (EMG).

A previously healthy 59-year-old woman presented with sudden onset weakness and numbness in her left side. Left limb muscle power was assessed as Medical Research Council (MRC) grade 2, and sensations of pinprick and light touch were also slightly decreased. Brain computed tomography (CT) revealed an acute hemorrhage in the right thalamus, associated with intra-ventricular hemorrhage. Twenty days later, her left limb muscle power improved to MRC grade 4. However, an involuntary, coarse tremor in the left lower extremity developed two months after the stroke. The tremor was present mainly when the patient was at rest, but postural...

Keywords

Electrophysiological Evaluation Left Lower Extremity Kinetic Tremor Thalamic Hemorrhage Medical Research Council Grade 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

We are very grateful to the technicians for supporting electrophysiologic evaluations.

Conflict of interest

We do not have any conflict of interest for our manuscript.

Supplementary material

Video legend A 59-year-old woman experienced a right thalamic hemorrhage. Two months after the stroke, she developed a combination of rest and postural tremor at a low frequency in her left lower limb. At the time of recording, the patient was not taking any medication in relation to the tremor. (Informed consent about the video script was obtained from the patient.) (WMV 8216 kb)

References

  1. 1.
    Lee MS, Marsden CD (1994) Movement disorders following lesions of the thalamus or subthalamic region. Mov Disord 9:493–507PubMedCrossRefGoogle Scholar
  2. 2.
    Miwa H, Hatori K, Kondo T, Imai H, Mizuno Y (1996) Thalamic tremor: case reports and implications of the tremor-generating mechanism. Neurology 46:75–79PubMedCrossRefGoogle Scholar
  3. 3.
    Krystkowiak P, Martinat P, Cassim F, Pruvo JP, Leys D, Guieu JD et al (2000) Thalamic tremor: correlations with three-dimensional magnetic resonance imaging data and pathophysiological mechanisms. Mov Disord 15:911–918PubMedCrossRefGoogle Scholar
  4. 4.
    Lera G, Scipioni O, Garcia S, Cammarota A, Fischbein G, Gershanik O (2000) A combined pattern of movement disorders resulting from posterolateral thalamic lesions of a vascular nature: a syndrome with clinico-radiologic correlation. Mov Disord 15:120–126PubMedCrossRefGoogle Scholar
  5. 5.
    Baysal L, Acarer A, Celebisoy N (2009) Post-ischemic Holmes’ tremor of the lower extremities. J Neurol 256:2079–2081PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2014

Authors and Affiliations

  1. 1.Department of NeurologyKyung Hee University College of Medicine, Kyung Hee University Hospital at GangdongSeoulKorea

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