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. 2022 Apr 26:jnnp-2021-327524.
doi: 10.1136/jnnp-2021-327524. Online ahead of print.

Functional tremor developing after successful MRI-guided focused ultrasound thalamotomy for essential tremor

Sohaila Alshimemeri  1   2 , Daniel Vargas-Méndez  1   3 , Robert Chen  1 , Nir Lipsman  4   5 , M L Schwartz  4   5 , Andres M Lozano  6   7 , Alfonso Fasano  8   7   9
Affiliations

Functional tremor developing after successful MRI-guided focused ultrasound thalamotomy for essential tremor

Sohaila Alshimemeri et al. J Neurol Neurosurg Psychiatry. .

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.

Keywords: FUNCTIONAL NEUROLOGICAL DISORDER; TREMOR.

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Conflict of interest statement

Competing interests: AML is consultant to Medtronic, Abbott, Boston Scientific and Insightec, and a Scientific Director at Functional Neuromodualtion. Other authors report no conflicts.

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