进行性多灶性白质脑病伴 Holmes 震颤经双侧脑深部电刺激治疗后好转。
Progressive Multifocal Encephalopathy Holmes Tremor Successfully Treated with Bilateral Deep Brain Stimulation.
机构信息
University of Louisville School of Medicine, Department of Neurology, US.
University of Louisville School of Medicine, Department of Neurosurgery, US.
出版信息
Tremor Other Hyperkinet Mov (N Y). 2023 Sep 1;13:31. doi: 10.5334/tohm.781. eCollection 2023.
BACKGROUND
We report a patient with bilateral HT treated with DBS.
CASE REPORT
A 58-year-old man diagnosed with HIV/AIDS and progressive multifocal leukoencephalopathy (PML) presented with 20 years of bilateral arm tremor refractory to therapy. DBS was implanted on the left ventral intermediate nucleus and posterior subthalamic area (VIM/PSA). One year later, a right VIM/PSA DBS was implanted. At twelve months, there were no significant side-effects. With his DBS turned off and on, the Fahn-Tolosa-Marin scale was rated 82 and 58, respectively.
DISCUSSION
To our knowledge, this is the first report of bilateral DBS VIM/PSA treating HT with no significant side effects.
HIGHLIGHTS
We report a successful treatment using deep brain stimulation of bilateral Holmes tremor that was caused by progressive multifocal encephalopathy. The patient achieved 30% improvement in tremor control with a meaningful improvement in his activities of daily living.
背景
我们报告了一例双侧 HT 患者接受 DBS 治疗的病例。
病例报告
一名 58 岁男性，诊断为 HIV/AIDS 和进行性多灶性白质脑病（PML），双侧手臂震颤 20 年，经治疗无效。在左侧腹侧中间核和后丘脑底核（VIM/PSA）植入 DBS。一年后，又在右侧 VIM/PSA 植入 DBS。12 个月时，无明显副作用。当 DBS 开启和关闭时，Fahn-Tolosa-Marin 量表的评分为 82 和 58。
讨论
据我们所知，这是首例双侧 DBS VIM/PSA 治疗 PML 引起的 HT 且无明显副作用的报告。
重点
我们报告了一例成功使用双侧 Holmes 震颤深部脑刺激治疗由进行性多灶性脑白质病引起的震颤的病例。患者的震颤控制改善了 30%，日常生活活动能力有了明显改善。
Zotero 插件