Subthalamic-thalamic DBS in a case with spinocerebellar ataxia type 2 and severe tremor-A unusual clinical benefit.
This is a single case report of a patient with spinocerebellar ataxia type 2 (SCA2) and severe tremor. Whereas disease progression with prevailing ataxia and dysmetria was slow over the first symptomatic 6 years, 6 months prior to operation were characterized by the development of a severe, debilitating postural tremor rendering the patient unable to independently sit, stand, speak, or swallow. Deep brain stimulation (DBS) at a subthalamic-thalamic electrode position almost completely arrested her tremor. The patient regained the functional state prior to her rapid disease progression allowing a restricted range of daily activities. Her condition has remained approximately stable over the two postoperative years to date. In addition to the efficacy of DBS on cerebellar tremor, the results illustrate a remarkable improvement of the patient's general condition and independence.
Freund
Hans-Joachim
HJ
Institute of Neuroscience and Biophysics 3, Research Center Jülich, Jülich, Germany. h.j.freund@fz-juelich.de
Barnikol
Utako B
UB
Nolte
Dagmar
D
Treuer
Harald
H
Auburger
Georg
G
Tass
Peter A
PA
Samii
Madjid
M
Sturm
Volker
V
D000203:Activities of Daily Living / Q000145:classification; D000328:Adult; D046690:Deep Brain Stimulation; D004567:Electrodes, Implanted; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D009460:Neurologic Examination; D020754:Spinocerebellar Ataxias / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D020531:Subthalamic Nucleus / Q000503:physiopathology*; D014103:Torticollis / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D016896:Treatment Outcome; D014202:Tremor / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D020651:Ventral Thalamic Nuclei / Q000503:physiopathology*