par Vengud, E.;Jacquy, Jean 
;Vanderkelen, Baudouin ;Manto, Mario
Référence Revue neurologique, 157, 6-7, page (682-687)
Publication Publié, 2001
;Vanderkelen, Baudouin ;Manto, Mario Référence Revue neurologique, 157, 6-7, page (682-687)
Publication Publié, 2001
Article révisé par les pairs
| Résumé : | We describe a patient who developed a tremor following a hemorrhage in the brainstem due to an arteriovenous malformation. Brain MRI disclosed lesions in the mesencephalon and a marked enlargement of the fourth ventricle. In addition to an asynchronous midbrain tremor in the upper limbs (frequency of 4.5-6 Hz), she exhibited short periods of 15-16 Hz synchronous tremor when upper limbs were maintained outstretched. These high-frequency bursts were absent in the lower limbs. The synchronous firing was relieved by hyperflexion of the wrists. We believe that the high-frequency discharges were due to the disruption of cerebellar pathways. Indeed, a similar tremor has been reported in patients presenting a symptomatic postural tremor associated with disruption of cerebellar afferences and/or efferences. We suggest that the disappearance of the high-frequency tremor following the hyperflexion of the wrist might be due to a resetting of the peripheral receptors (muscle spindles) activity, in agreement with the hypothesis that the stretch reflexes associated with postural tasks are impaired in patients exhibiting cerebellar ataxia. |
