Tremor induced by toluene misuse successfully treated by a Vim thalamotomy
- aDepartment of Neurological Surgery, bDepartment of Neurology, Kaizuka Hospital, 7–7–27 Hakozaki, Japan, cDepartment of Clinical Neurophysiology, Neurological Institute, Faculty of Medicine, Kyushu University, 3–1–1 Maidashi, Higashi-Ku, Fukuoka 812, Japan
- Dr Yasushi Miyagi, Department of Neurological Surgery, Kaizuka Hospital, 7–7–27 Hakozaki, Higashi-Ku, Fukuoka 812, Japan. Telephone 0081 92 632 3333; fax 0081 92 632 2230.
- Received 21 August 1998
- Revised 8 December 1998
- Accepted 1 December 1998
A 22 year old man developed a vigorous tremor of 5 Hz in his right hand, after a 7 year history of toluene misuse. T2 Weighted MRI depicted marked decreases in the signal intensity of the basal ganglia, red nucleus, and thalamus on both sides. The stereotactic coagulation of the left nucleus ventrointermedius (Vim) of the thalamus abolished the tremors in his right hand. This patient clearly exhibited the pathological involvement of rubral lesions in generation of a toluene induced tremor on MRI. Toluene induced tremor is an irreversible symptom which persists even after stopping toluene misuse, therefore in medically intractable cases, it should be positively treated by a Vim thalamotomy.