{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T10:57:33Z","timestamp":1778756253530,"version":"3.51.4"},"reference-count":17,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2017,7,10]]},"abstract":"<jats:p>Holmes\u2019 tremor is a low-frequency hand tremor and has varying amplitude at different phases of motion. It is usually unilateral and does not respond satisfactorily to drugs and thus considered irreversible. Structural lesions in the thalamus and brainstem or cerebellum are usually responsible for Holmes\u2019 tremor. We present a 23-year-old woman who presented with unilateral Holmes\u2019 tremor. She also had hypersomnolence and headache in the sitting posture. Her brain imaging showed brain sagging and deep brain swelling due to spontaneous intracranial hypotension (SIH). She was managed conservatively and had a total clinical and radiological recovery. The brain sagging with the consequent distortion of the midbrain and diencephalon was responsible for this clinical presentation. SIH may be considered as one of the reversible causes of Holmes\u2019 tremor.<\/jats:p>","DOI":"10.1136\/bcr-2017-220348","type":"journal-article","created":{"date-parts":[[2017,7,27]],"date-time":"2017-07-27T23:50:19Z","timestamp":1501199419000},"page":"bcr-2017-220348","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Reversible Holmes' tremor due to spontaneous intracranial hypotension"],"prefix":"10.1136","volume":"2017","author":[{"given":"Rajesh Shankar","family":"Iyer","sequence":"first","affiliation":[{"name":"Department of Neurology, KG Hospital, Coimbatore, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pandurang","family":"Wattamwar","sequence":"additional","affiliation":[{"name":"Department of Neurology, United CIIGMA Hospitals, Aurangabad, Maharashtra, 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