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.
- FUNCTIONAL NEUROLOGICAL DISORDER
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Contributors SA and AF designed and conceptualised the study, had a major rule in data acquisition and drafting/revising the manuscript. DV-M and RC had a major role in analysis and interpretation of the data. AML, NL and MLS had a major role in revising the manuscript for intellectual content.
Competing interests AML is consultant to Medtronic, Abbott, Boston Scientific and Insightec, and a Scientific Director at Functional Neuromodualtion. Other authors report no conflicts.
Provenance and peer review Not commissioned; externally peer reviewed.
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