Alshimemeri Sohaila, Vargas-Méndez Daniel, Chen Robert, Lipsman Nir, Schwartz M L, Lozano Andres M, Fasano Alfonso
Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, UHN, Toronto Western Hospital, Toronto, Ontario, Canada.
Neurology Unit, Department of Medicine, King Saud University, Riyadh, Riyadh Province, Saudi Arabia.
J Neurol Neurosurg Psychiatry. 2022 Apr 26. doi: 10.1136/jnnp-2021-327524.
To describe a case of functional tremor occurring after a successful MR-guided focused ultrasound thalamotomy (MRgFUS) for essential tremor.
A 71-year-old right-handed man with essential tremor was referred to us for consideration of deep brain stimulation surgery for worsening bilateral upper limb tremor after a successful left MRgFUS for essential tremor.
On clinical exam, signs compatible with a functional tremor were noted, including entertainability and suppressibility. Electrophysiological studies were consistent with essential tremor and superimposed tremor fulfilling the laboratory-supported criteria for functional tremor.
We describe the first reported case of a functional movement disorder occurring after successful MRgFUS procedure for essential tremor. Recognising this entity and its development after such therapeutic interventions is essential to avoid further unnecessary invasive therapies.
描述一例在成功进行磁共振引导聚焦超声丘脑切开术（MRgFUS）治疗特发性震颤后发生的功能性震颤病例。
一名71岁右利手男性，患有特发性震颤，在成功进行左侧MRgFUS治疗特发性震颤后，因双侧上肢震颤加重前来我院考虑行脑深部电刺激手术。
临床检查发现符合功能性震颤的体征，包括可诱发性和可抑制性。电生理研究结果与特发性震颤及叠加性震颤相符，后者符合功能性震颤的实验室支持标准。
我们描述了首例成功进行MRgFUS治疗特发性震颤后发生功能性运动障碍的报道病例。认识到这一实体及其在这种治疗干预后的发展对于避免进一步不必要的侵入性治疗至关重要。
