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Catherine Cho, BS; Lawrence M. Samkoff, MD

Arch Neurol. 2000;57:1353-1355.

Background  Thalamic tremor is typically characterized by resting and intention components; a postural element is often present as well. Previously reported cases of acquired thalamic tremor have demonstrated lesions in the posterior thalamus or dentatorubrothalamic tract.

Objectives  To report a case of dystonic-postural tremor of the upper extremity that occurred after a contralateral anterior thalamic infarct, and to discuss potential tremorigenic mechanisms.

Design  Case report.

Setting  Municipal hospital neurology clinic.

Patient  A 65-year-old right-handed woman suddenly developed a dystonic tremor in her left hand after undergoing coronary bypass surgery. The tremor persisted unchanged for 8 months, at which time she was evaluated by us. Cranial magnetic resonance imaging scans demonstrated a right anterior thalamic infarct.

Conclusion  To our knowledge, this is the first report of focal tremor caused by a lesion of the anterior thalamus.

From the Department of Neurology, New York Medical College, Valhalla, NY, and Metropolitan Hospital Center, New York, NY.