Levodopa-responsive Holmes' Tremor Caused by a Single Inflammatory Demyelinating Lesion.

Autor:	Katschnig-Winter P; Department of Neurology, Medical University of Graz, Graz, Austria., Koegl-Wallner M; Department of Neurology, Medical University of Graz, Graz, Austria., Pendl T; Department of Neurology, Medical University of Graz, Graz, Austria., Fazekas F; Department of Neurology, Medical University of Graz, Graz, Austria., Schwingenschuh P; Department of Neurology, Medical University of Graz, Graz, Austria ; Division of Neuroradiology, Department of Radiology, Medical University of Graz, Graz, Austria.
Jazyk:	angličtina
Zdroj:	Tremor and other hyperkinetic movements (New York, N.Y.) [Tremor Other Hyperkinet Mov (N Y)] 2015 Sep 25; Vol. 5, pp. 339. Date of Electronic Publication: 2015 Sep 25 (Print Publication: 2015).
DOI:	10.7916/D8WQ033X
Abstrakt:	Background: Holmes' tremor is characterized by a combination of rest, postural, and kinetic tremor that is presumably caused by interruption of cerebello-thalamo-cortical and nigrostriatal pathways. Medical treatment remains unsatisfactory. Case Report: A 16-year-old girl presented with Holmes' tremor caused by a transient midbrain abnormality on magnetic resonance imaging (MRI). To explore the discrepancy between persistent tremor and resolved MRI changes, we performed dopamine transporter single-photon emission computed tomography (DaT-SPECT) with a 123I-ioflupane that revealed nearly absent DaT binding in the right striatum. Levodopa dramatically improved the tremor. Discussion: This is only the second report of a transient midbrain MRI abnormality disrupting nigrostriatal pathways. The case highlights the sometimes limited sensitivity of morphologic imaging for identifying the functional consequences of tissue damage and confirms that DaT imaging may serve as a predictor for levodopa responsiveness in Holmes' tremor.
Databáze:	MEDLINE
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