Miyagi Y, Shima F, Ishido K, Yasutake T, Kamikaseda K
Department of Neurological Surgery, Kaizuka Hospital, 7-7-27 Hakozaki, Japan.
J Neurol Neurosurg Psychiatry. 1999 Jun;66(6):794-6. doi: 10.1136/jnnp.66.6.794.
A 22 year old man developed a vigorous tremor of 5 Hz in his right hand, after a 7 year history of toluene misuse. T2 Weighted MRI depicted marked decreases in the signal intensity of the basal ganglia, red nucleus, and thalamus on both sides. The stereotactic coagulation of the left nucleus ventrointermedius (Vim) of the thalamus abolished the tremors in his right hand. This patient clearly exhibited the pathological involvement of rubral lesions in generation of a toluene induced tremor on MRI. Toluene induced tremor is an irreversible symptom which persists even after stopping toluene misuse, therefore in medically intractable cases, it should be positively treated by a Vim thalamotomy.
一名22岁男子在有7年甲苯滥用史后，右手出现了5赫兹的剧烈震颤。T2加权磁共振成像显示双侧基底神经节、红核和丘脑的信号强度明显降低。丘脑左腹中间核（Vim）的立体定向凝固消除了他右手的震颤。该患者在磁共振成像上清楚地显示了红核病变在甲苯诱导震颤发生中的病理参与。甲苯诱导的震颤是一种不可逆的症状，即使停止甲苯滥用后仍会持续，因此在药物治疗难以控制的病例中，应积极采用丘脑腹中间核切开术进行治疗。
