Hemi-parkinsonism and return of essential tremors after MRgFUS thalamotomy: Case report and review of procedural complications affecting ventral thalamic nuclei

eNeurologicalSci

Nicole R. Villemarette-Pittman¹  Aditi Vian Varma-Doyle²  Brian J. Copeland³ 

[1] Louisiana State University Health Sciences Center – New Orleans School of Medicine, Department of Neurology, New Orleans, LA, USA;Corresponding author at: Department of Neurology -LSUHSC Department of Neurology –LSUHSC, 1542 Tulane Ave, 1542 Tulane Ave, Room 763, New Orleans, LA 70112, USA.;Louisiana State University Health Sciences Center – New Orleans School of Medicine, Department of Neurology, New Orleans, LA, USA;

关键词: MRgFUS thalamotomy;    VIM nucleus;    Dysarthria;    Essential tremors;    Ventrolateral thalamic nucleus;    Parkinsonism;   

DOI  :  

来源: DOAJ

【 摘 要 】

Magnetic resonance guided focused ultrasound (MRgFUS) thalamotomy targets the ventral intermediate nucleus of the thalamus and has been shown to be safe and effective to treat medication-resistant essential tremors. Improvement in tremor scores, posture and action scores, disability scores and quality of life scores have been reported in patients treated with this procedure. Adverse events are usually transient and non-severe. We present a patient who underwent MRgFUS thalamotomy of the left VIM and developed new-onset parkinsonian features predominantly on the right side and return of essential tremors a few years after the procedure. Changes in speech (hypophonia and dysarthria), gait imbalance and postural instability, bradykinesia, and cogwheeling rigidity occurred, likely due to involvement of the fiber tracts through the ventrolateral subnuclei and the adjacent ventral anterior thalamic nuclei and other surrounding structures. We describe side effects of MRgFUS thalamotomy in our patient compared to previous reports and review the thalamic nuclei and surrounding structures that can be affected during procedure, causing these effects.

【 授权许可】

Unknown