@article{ref1,
title="A rare case of Holmes tremor in a worker with occupational carbon monoxide poisoning",
journal="American journal of industrial medicine",
year="2021",
author="Rutchik, Jonathan and Bowler, Rosemarie M. and Ratner, Marcia H.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="Parkinsonism and encephalopathy are frequently seen in patients who survive carbon monoxide (CO) poisoning. Neurological findings associated with CO poisoning can emerge immediately after cessation of exposure or following a brief period of pseudo-recovery. When present, the tremor associated with CO poisoning is typical of the postural/intention type. Here, we report on a rare case of toxic encephalopathy with a dominant-hand Holmes-type tremor, characterized by resting, as well as postural and kinetic/intentional components, in a previously healthy 53-year-old man exposed to CO while actively engaged in the process of performing a physically demanding skilled labor task. The unique neuropathological and functional changes that give rise to Holmes-type tremor and how this relates to the selective vulnerability of the inhibitory indirect pathway of the basal ganglia to glutamatergic excitotoxicity mediated by tissue hypoxia are discussed.<p /> <p>Language: en</p>",
language="en",
issn="0271-3586",
doi="10.1002/ajim.23235",
url="http://dx.doi.org/10.1002/ajim.23235"
}