Objective: To describe a patient with Holmes’ head tremor secondary to neurocysticercosis.

Background: Holmes tremor, frequently unilateral and affecting upper limbs, is usually secondary to lesions affecting the cerebello-rubro-thalamic system. The clinical spectrum of neurocysticercosis can range from asymptomatic brain lesions to mimicking any neurological disorder, being seizures the most common presentation. Movement disorders are rare in neurocysticercosis.

Method: A 49-year-old male presented with slow, regular cervical involuntary movements at rest, worsening during voluntary movements. Brain MR showed multiple focal lesions with calcifications involving both hemispheres, midbrain and cerebellum. One lesion was settled in the left red nucleus. EEG showed no epileptiform activity.

Results: Holmes’ head tremor secondary to neurocysticercosis was diagnosed. The tremor did not respond to beta-blockers nor to primidone. Partial improvement after botulinum toxin infiltrations was observed.

Conclusion: Holmes’ head tremor might be part of the clinical spectrum of neurocysticercosis.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/holmes-head-tremor-secondary-to-neurocysticercosis/