Division of Neurology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 500 West Thomas Road, Suite 300, Phoenix, AZ 85013, USA.
Neurol Sci. 2011 Dec;32(6):1157-60. doi: 10.1007/s10072-011-0600-x. Epub 2011 May 10.
We describe the case of a 33-year-old woman who presented with a 2-month history of worsening head tremor. The medical evaluation led to the new diagnosis of MS and the MRI of brain demonstrated prominently active disease. Intravenous rituximab was started according to the HERMES trial, and significant improvement was noted. She has received additional rituximab dosing approximately every 6 months, and at the 2-year follow-up the tremor has not recurred. The resolution of head tremor likely resulted from the complete suppression of MS disease activity, which must have allowed restoration of normal neural circuitry. In agreement with a growing body of evidence that supports early control of MS disease activity to prevent accumulation of fixed disability, this case advocates for aggressive immunological therapy at the onset of tremor in MS patients.
我们描述了一位 33 岁女性的病例，她因进行性加重的头部震颤就诊，病史已有 2 个月。医学评估导致了新的多发性硬化症诊断，脑部 MRI 显示明显活跃的疾病。根据 HERMES 试验开始静脉注射利妥昔单抗，观察到显著改善。她大约每 6 个月接受额外的利妥昔单抗剂量，在 2 年随访时震颤未再发作。头部震颤的缓解可能是由于多发性硬化症疾病活动的完全抑制，这必须允许正常神经回路的恢复。越来越多的证据支持早期控制多发性硬化症疾病活动以防止固定残疾的积累，本病例主张在多发性硬化症患者震颤发作时进行积极的免疫治疗。
