2022•Journal of Neurology Neurosurgery & PsychiatryRequires access
Functional tremor developing after successful MRI-guided focused ultrasound thalamotomy for essential tremor
Sohaila Alshimemeri, Daniel Vargas-Méndez, Robert Chen, Nir Lipsman, Michael L. Schwartz, Andrés M. Lozano, Alfonso Fasano
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Abstract
OBJECTIVE: To describe a case of functional tremor occurring after a successful MR-guided focused ultrasound thalamotomy (MRgFUS) for essential tremor. METHODS: 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. RESULTS: 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. DISCUSSION: 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.