Lyons Mark, Shneyder Natalya, Evidente Virgilio
Mayo Clinic Arizona, Department of Neurological Surgery, Phoenix, AZ, USA.
Turk Neurosurg. 2013;23(1):122-4. doi: 10.5137/1019-5149.JTN.4425-11.0.
Primary writing tremor is a task associated tremor which occurs during and interferes with handwriting. Considered in most cases to be a nonprogressive disorder, a number of patients are significantly debilitated by the disease. The pathophysiology of the disorder is not fully understood, but felt to represent a variant of either essential tremor or dystonia versus a separate entity. Treatment has been limited to medications, writing devices and botulinum toxin type A for most patients. Recently, deep brain stimulation has been reported in a few patients as an effective option for those patients with medically refractory symptoms. We report our experience in a patient with primary writing tremor who underwent successful thalamic deep brain stimulation, discuss the current theories on the pathophysiology of the disorder and review the current literature of deep brain stimulation for refractory primary writing tremor.
原发性书写震颤是一种与任务相关的震颤，在书写过程中出现并干扰书写。在大多数情况下，它被认为是一种非进行性疾病，但仍有许多患者因该疾病而严重致残。这种疾病的病理生理学尚未完全了解，但被认为是特发性震颤或肌张力障碍的一种变体，而非一种独立的疾病。对于大多数患者，治疗方法仅限于药物、书写辅助工具和A型肉毒杆菌毒素。最近，有报道称，对于药物治疗无效的患者，深部脑刺激是一种有效的治疗选择。我们报告了一名接受丘脑深部脑刺激手术成功的原发性书写震颤患者的治疗经验，讨论了该疾病病理生理学的当前理论，并回顾了难治性原发性书写震颤的深部脑刺激治疗的当前文献。
