RUBRAL TREMOR AFTER THALAMIC HEMORRHAGE

Tremors in association with thalamic haemorrhage have been infrequently reported, and delayed rubral tremor as a complication of such an event is quite rare. We describe a patient with a combined resting-postural-kinetic tremor due a thalamic haemorrhage. Magnetic resonance imaging showed evidence of a subthalamic involvement but failed to reveal any mesencephalic lesion. Five years after the original stroke there was rapid and almost complete suppression of her abnormal movements, probably related to an ischaemic capsular lesion. Involuntary movements, which resemble rubral tremor, can be due to lesions upstream of the rubral and nigral outflow system.