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MR-guided focused ultrasound thalamotomy for lithium-induced tremor: a case report and literature review.

Gelman et al., Front Neurol 2023
<!– DOI: 10.3389/fneur.2023.1331241 //–>
https://doi.org/10.3389/fneur.2023.1331241

Drug-induced tremor, particularly from lithium, affects about 25% of patients, presenting a significant treatment challenge. Traditional medical treatments often fall short, and while Deep Brain Stimulation (DBS) has shown some effectiveness, it is invasive. This case study introduces MR-guided focused ultrasound (MRgFUS) thalamotomy as a novel, non-invasive treatment option for drug-induced tremor, a method previously FDA-approved only for essential tremor (ET).

The subject, a 55-year-old left-handed man with a severe lithium-induced tremor in both upper extremities, underwent MRgFUS thalamotomy targeting the right ventral intermediate nucleus (VIM) of the thalamus. The procedure resulted in almost complete resolution of his left-hand tremor immediately, with no side effects. This positive outcome persisted at the 90-day follow-up.

This case is significant as it suggests MRgFUS thalamotomy could be a groundbreaking treatment for drug-induced tremor, expanding its application beyond ET and offering a non-invasive alternative to DBS.

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