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Journal of Neurology, Neurosurgery, and Psychiatry 2003;74:258-259; doi:10.1136/jnnp.74.2.258
Copyright © 2003 by the BMJ Publishing Group Ltd.
Journal of Neurology Neurosurgery and Psychiatry 2003;74:258-259
© 2003 BMJ Publishing Group

SHORT REPORT

Ataxic arm movements after thalamotomy for Parkinsonian tremor

T E Kimber1, B P Brophy2 and P D Thompson1

1 University Department of Medicine and Department of Neurology, Royal Adelaide Hospital and University of Adelaide, Adelaide, Australia
2 Department of Neurosurgery, Royal Adelaide Hospital

Correspondence to:
Correspondence to:
Professor P D Thompson, University Department of Medicine, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia 5000;
philip.thompson{at}adelaide.edu.au

ABSTRACT

Voluntary finger–nose movements of the arm were analysed in six patients undergoing stereotaxic nucleus ventralis intermedius thalamotomy for relief of severe Parkinsonian tremor. In all cases thalamotomy acutely abolished tremor in the contralateral arm. In the early postoperative phase, ataxia of the arm contralateral to the operated side was also seen. Ataxia was transient, lasting between 7 and 21 days postoperatively. This observation suggests that a lesion of the Vim nucleus interrupts cerebellar input to the thalamus, and supports the concept that abnormal cerebellar activity is an important contributor to the generation of tremor in Parkinson’s disease.

Keywords: thalamotomy; ataxia


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