Holmes tremor with impairment of the Guillain-Mollaret triangle following medullar hemorrhage
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Holmes tremor (HT) is a symptomatic tremor of slow frequency (usually less than 4.5 Hz) and irregular amplitude, with or without ataxia. HT is usually attributed to pathogenic lesions involving the cerebello-thalamo-cortical, dopaminergic nigrostriatal system or the Guillain–Mollaret triangle (GMT) [1, 2]. The GMT is composed of fibers between the red nucleus, the ipsilateral inferior olivary nucleus (IONS), and the contralateral dentate nucleus . It was reported that the most common causes of HT were vascular lesions, among which midbrain, thalamus, and cerebellum were the most frequently affected regions. However, lesions in medulla oblongata have rarely reported in patients with HT so far . In the current study, we presented a HT patient caused by medulla oblongata hemorrhage. Diffusion tensor imaging (DTI) demonstrates the insults of GMT.
The authors sincerely thank the patient for his help and willingness to take part in this study.
This work was supported by grant 81571100 from the National Natural Science Foundation of China.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest.
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