Attenuation of cerebellar tremor with implantation of an intrathecal baclofen pump: the role of gamma-aminobutyric acidergic pathways. Case report.
The authors present the case of a 49-year-old woman with disabling bilateral upper-extremity cerebellar tremor that resolved unexpectedly after placement of an intrathecal baclofen pump for lower-extremity spasticity. The tremor amplitude decreased nearly linearly with increasing intrathecal baclofen dosage, and disappeared completely at a dose of 250 microg/day. In this report the authors demonstrate the role of the gamma-aminobutyric acidergic system in the pathogenesis of cerebellar tremor, and these findings may lead to a new treatment modality for patients disabled by this manifestation of their disease.
Department of Neurosurgery, Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA.
Nirit
N
Weiss
Richard B
RB
North
Shinji
S
Ohara
Frederick A
FA
Lenz
D001418:Baclofen / Q000008:administration & dosage / Q000627:therapeutic use*; D002531:Cerebellum / Q000503:physiopathology*; D005260:Female; D018755:GABA Agonists / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D015918:Infusion Pumps, Implantable; D007278:Injections, Spinal; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications; D018079:Receptors, GABA / Q000502:physiology*; D014202:Tremor / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology*; D005680:gamma-Aminobutyric Acid
D018755:GABA Agonists; D018079:Receptors, GABA; D005680:gamma-Aminobutyric Acid; D001418:Baclofen