Synonyms:
Holmes tremor
Diagnosis:
This is a clinical diagnosis in the correct clinical context (damage to the midbrain)
Clinical:
Mainly unilateral tremor, low frequency (3–5 Hz)
Occurs at rest, in posture and during movement
Exacerbation by goal-directed movements.
Disappears during sleep
Findings on investigations:
- MRI: lesions in brain stem, cerebellum or thalamus
Treatment:
Consider Levetiracetam LEV