接受脑深部电刺激治疗的人类免疫缺陷病毒免疫重建炎性综合征患者出现获得性霍姆斯震颤。
Acquired Holmes Tremor in a Human Immunodeficiency Virus Immune Reconstitution Inflammatory Syndrome Patient Treated with Deep Brain Stimulation.
机构信息
Riverside University Health System, Department of Neurosurgery, Riverside, California, USA.
Western University of Health Science, College of Osteopathic Medicine, Pomona, California, USA.
出版信息
World Neurosurg. 2020 Sep;141:253-259. doi: 10.1016/j.wneu.2020.06.099. Epub 2020 Jun 19.
BACKGROUND
The authors present a case of a 66-year-old male who was diagnosed with human immunodeficiency virus, and his medical course of highly active antiretroviral therapy was complicated with the development of immune reconstitution inflammatory syndrome, which led to development of movement disorder consisting of right-sided resting tremor, neck dystonia, and jaw clenching.
CASE DESCRIPTION
The patient's symptoms resembled that of rubral tremor, and he underwent placement of a deep brain stimulation electrode into the left ventral intermediate nucleus of the thalamus with significant improvement of symptoms.
CONCLUSIONS
This is the first reported case in the literature of a human immunodeficiency virus-positive patient's treatment course complicated with immune reconstitution inflammatory syndrome with neurologic manifestation, which was refractory to medical therapy and thus treated with deep brain stimulation.
背景
作者报告了一例 66 岁男性患者，该患者被诊断为人免疫缺陷病毒（HIV）阳性，其高效抗逆转录病毒治疗（HAART）的医疗过程中出现了免疫重建炎症综合征（IRIS），导致运动障碍的发展，包括右侧静止性震颤、颈部肌张力障碍和下颌紧闭。
病例描述
患者的症状类似于红核震颤，他接受了深部脑刺激电极植入左丘脑腹侧中间核的治疗，症状显著改善。
结论
这是首例文献报道的 HIV 阳性患者免疫重建炎症综合征伴发神经系统表现的病例，该病例对药物治疗有抗药性，因此采用了深部脑刺激进行治疗。
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