Although stereotactic thalamotomy is the mainstay in the surgical treatment of tremor in patients with Parkinson's disease (PD), this surgery is not favored and is even a matter of potential concern in the treatment of leg tremor since it carries a significant risk of injury to the internal capsule. In this study we have carried out a quantitative assessment of leg tremor alleviation in 12 patients with PD after MRI-/microelectrode-guided stereotactic ablation of the posterior part of the globus pallidus internus (GPi). The results showed that posterior GPi pallidotomy combined with drug therapy is a satisfactorily effective therapeutic strategy to treat parkinsonian leg tremor.
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BMJ Case Rep
January 2025
Internal Medicine, East Suffolk and North Essex NHS Foundation Trust Ipswich Hospital, Ipswich, UK.
This case report presents a complex medical scenario involving early 60s female patient with a history of chronic lymphocytic leukaemia (CLL) complicated by Evans syndrome, characterised by autoimmune haemolytic anaemia and immune thrombocytopenia. The patient had received various treatments, including steroids, rituximab, cyclosporine and acalabrutinib. The patient's neurological symptoms began around 3 years prior to presentation, with shaking of her right leg, followed by shaking of both hands, particularly the left hand.
View Article and Find Full Text PDFVet J
December 2024
Norwegian Meat and Poultry Research Centre, Animalia AS, Postboks 396 Økern, Oslo 0513, Norway.
Congenital tremor (CT) caused by atypical porcine pestivirus (APPV) is a widespread disease in the swine industry. It is characterized by tremors in newborn piglets, but tremor description and association to other clinical signs are not well documented. This study's objectives were to characterize general and neurological clinical signs of APPV-induced CT and describe the progression and associations between the different signs.
View Article and Find Full Text PDFMov Disord
October 2024
Edmond J. Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Toronto, Ontario, Canada.
Background: Orthostatic tremor (OT) is a rare movement disorder characterized by a feeling of unsteadiness and a high-frequency tremor in the legs (13-18 Hz) relieved by sitting or walking.
Objectives: The aims were to study the brain electrophysiology captured chronically in a person with medication-refractory OT while standing and walking and in the semi-recumbent position using bilateral ventral intermedius nucleus deep brain stimulation (DBS) (Medtronic Percept PC) and to describe the clinical use of closed-loop DBS.
Methods: A sensing survey was used to capture baseline local field potentials (LFPs) while standing.
JCEM Case Rep
October 2024
Division of Endocrinology, Diabetes and Metabolism, Virginia Commonwealth University Department of Internal Medicine, Richmond, VA 23298, USA.
Thyroid storm is a life-threatening complication of hyperthyroidism that necessitates early diagnosis for aggressive, effective treatment. We present a patient with a newly diagnosed multinodular goiter who presented to the emergency department with leg swelling, dyspnea, tremors, and atrial fibrillation with elevation in thyroid hormone levels consistent with thyrotoxicosis. Despite improvement in peripheral hormone levels on maximized medical treatment with beta-blockers, methimazole, glucocorticoids, cholestyramine, and potassium iodide, she continued to clinically decline with new encephalopathy, heart failure, and liver and kidney dysfunction while receiving treatment.
View Article and Find Full Text PDFEur J Hosp Pharm
August 2024
Management Department, Hospital Universitari i Politècnic La Fe, València, Spain.
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