Pathology of Symptomatic Tremors

Authors

  • Marie Vidailhet,

    Corresponding author
    1. Department of Neurology, Hǒpital Saint Antoine and INSERM U289, Hǒpital de la Salpětrière, Paris
    • Dr. Marie Vidailhet, Hǒpital Saint Antoine, 184 rue du Faubourg Saint Antoine, 75012 Paris CEDEX. France
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  • Charles-Pierre Jedynak,

    1. Department of Neurosurgery, CMC Foch, Suresnes, Department of Clinical and Biological Neurosciences, University of Grenoble, France
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  • Pierre Pollak,

    1. Department of Neurosurgery, CMC Foch, Suresnes, Department of Clinical and Biological Neurosciences, University of Grenoble, France
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  • Yves Agid

    1. Department of Neurology, Hǒpital Saint Antoine and INSERM U289, Hǒpital de la Salpětrière, Paris
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Abstract

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-thalamocortical 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.

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