Case report: Utilization of benzodiazepine to manage rural tremor in patient with spontaneous hemorrhage

2^nd World Physical Medicine and Rehabilitation Conference

June 13-14, 2019 Helsinki, Finland

Rebecca Haigh

Haywood Hospital, UK

Posters & Accepted Abstracts: Physiother Rehabil

Abstract :

Rubral tremor more recently known as Holmes tremor is characterized by its onset a period of time following injury. Holmes tremor is described as a flexor-extension oscillation, present at rest and exacerbated by posture1. This tremor is further exacerbated by action. These characteristics have a profound effect on the patient, increasing lethargy and notably patient frustration, all of which negatively impact on a patient working towards rehabilitation goals. Multiple individual case reports have shown limited benefits of a range of medications including Levodopa and a few describing use of Benzodiazepine. Recent retrospective case study has found limited evidence to support use of Benzodiazepines and favors Levodopa as a pharmacologic agent2. It is important to consider that the majority of case reports and research suggest the only curative method is surgical. Case of 32 year old female initially presented with slow progression following spontaneous intra ventricular hemorrhage. Six weeks following initial injury she developed a global coarse tremor significantly limiting rehabilitation progress. On sitting out and particularly on intention the amplitude of the tremor greatly intensified making rehabilitation goals difficult to achieve particularly when taking into consideration associated lethargy. It was noted during this time that the tremor was improved significantly by use of tilt table. She initially showed a marked response to Lorazepam but this was difficult to titrate due to sedative affect and she was converted to Clonazepam. This input has caused a marked reduction in tremor with reduced lethargy and improved engagement with therapies.

Biography :

Rebecca Haigh BMBS studied medicine at Peninsula College of Medicine and Dentistry, graduating in 2014. On completion of her medical training she took up a Specialty Doctor post in neurorehabilitation with an interest in spasticity management.