一例罕见的特发性震颤脑深部电刺激病例：电极位置在哪里？
An Unusual Case of Essential Tremor Deep Brain Stimulation: Where is the Lead?
作者信息
Spears C Chauncey, Almeida Leonardo, Okun Michael S, Deeb Wissam
机构信息
Department of Neurology, University of Michigan, Ann Arbor, MI, US.
Fixel Center for Neurological Diseases, Program in Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville, FL, US.
出版信息
Tremor Other Hyperkinet Mov (N Y). 2019 Mar 7;9:617. doi: 10.7916/d8-xj6w-cm53. eCollection 2019.
CLINICAL VIGNETTE
A 73-year-old female with essential tremor (ET) underwent bilateral thalamic ventralis intermedius (Vim) deep brain stimulation (DBS) surgery. The leads provided tremor benefit, but the location was suboptimal and contributed to stimulation-induced hemichorea.
CLINICAL DILEMMA
Can patients with ET derive benefit when stimulating outside the Vim? What do we know about stimulation-induced hemichorea in the setting of ET?
CLINICAL SOLUTION
Lead localization combined with advanced programming strategies can be employed to troubleshoot DBS in settings when benefits are observed along with adverse effects.
GAP IN KNOWLEDGE
Sparse information exists about DBS when applied to neuroanatomic regions outside the Vim for the management of ET. Subthalamic nucleus DBS-induced chorea has been reported in multiple movement disorders, but not in ET.
临床病例
一名73岁患有特发性震颤（ET）的女性接受了双侧丘脑腹中间核（Vim）深部脑刺激（DBS）手术。电极带来了震颤改善效果，但位置不理想，导致了刺激诱发的偏侧舞蹈症。
临床困境
特发性震颤患者在Vim以外的部位进行刺激能否获益？在特发性震颤情况下，我们对刺激诱发的偏侧舞蹈症了解多少？
临床解决方案
当观察到有益效果并伴有不良反应时，可采用电极定位结合先进的程控策略来解决DBS相关问题。
知识空白
关于DBS应用于Vim以外的神经解剖区域治疗特发性震颤的信息稀少。在多种运动障碍中已报道了丘脑底核DBS诱发的舞蹈症，但在特发性震颤中未见报道。
Zotero 插件