There are various 'oscillation generators' in the central nervous system whose activity could provoke tremors 1. Among them, the ventralis intermedius (VIM) nucleus of the thalamus, the cerebellar dentate and red nuclei, and the inferior olive are the most relevant, constituting the olivo-cere-bello-thalamic circuits 1. Neuronal oscillatory activity may also be generated in the, basal ganglia, as has been demonstrated in Parkinson's disease (PD) 1. All these nuclei are interconnected. Thus their oscillatory activity could converge at the VIM level, which explains the remarkable efficacy of thalamic surgery against all types of tremor 2. However, there could be independent oscillators according to the phenomenology and somatotopy of the tremor 1. We report on the case of a patient who presented tremors of diverse etiology, showing different responses to different therapeutic approaches and thus supporting this last possibility.
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