Table 2.
Phenotypes in cerebellar tremors.
Type of cerebellar tremor | Phenomenology | Responsible region |
---|---|---|
Kinetic tremor in Holmes' classic study | • Irregular and discontinuous sways • Sometimes marked at the beginning of the movement |
The cerebellum (probably destruction of the cerebellar cortex and/or the white matter) |
Static tremor in Holmes' classic study | • Subtype 1: Irregular oscillation in the extension of upper limbs during the maintenance of the limb against gravity • Subtype II: Regular oscillations of a limb or some of its segments during maintenance of the limb accurately in certain positions |
The cerebellum (probably destruction of the cerebellar cortex and/or the white matter) |
Intention tremor | • Amplitude increase during visually guided movements toward a target at the movement termination | The dentato-rubro-thalamic tract |
“Holmes' tremor” | • Concomitant expression of rest tremor* and intention tremor with/without postural tremor* • Slow frequency, usually <4.5 Hz • Late onset of pathologies |
Superior peduncle, midbrain tegmentum, and posterior thalamus |
Palatal tremor | • Rhythmic movements of the soft palate • Late onset of pathologies |
The brainstem and the cerebellum |
Essential tremor | • Bilateral, largely symmetric postural tremor or kinetic tremor* • Involving hands and forearm, with or without head tremor and tremor in other locations |
Cerebellar cortex |
Kinetic tremor, tremor occurring during any voluntary movement; postural tremor, tremor present while voluntarily maintaining a position against gravity; rest tremor, tremor that occurs in a body part that is not voluntarily activated and is completely supported against gravity.
Definition by Consensus Statement of the Movement Disorder Society on Tremor (11).