Elma A Chowdhury, Vijay Sivan, Rohit Prem Kumar, Francis F Ruzicka Iv, Hooman Azmi
{"title":"Delayed clinical response to focused ultrasound thalamotomy in essential tremor in a patient with suboptimal skull density ratio - A case report.","authors":"Elma A Chowdhury, Vijay Sivan, Rohit Prem Kumar, Francis F Ruzicka Iv, Hooman Azmi","doi":"10.25259/SNI_707_2024","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Magnetic resonance imaging-guided focused ultrasound (MRgFUS) thalamotomy offers incisionless treatment for essential tremor or tremor-dominant Parkinson's disease, gaining acceptance as an alternative to deep brain stimulation. Compared to other methods, it offers real-time efficacy assessment without ionizing radiation.</p><p><strong>Case description: </strong>A 63-year-old male underwent MRgFUS, initially yielding subtle results due to skull limitations. However, significant tremor relief emerged 6 hours post-procedure, sustained for 5 days. Imaging confirmed thalamotomy effect. A second treatment was delivered at day five for longevity.</p><p><strong>Conclusion: </strong>For patients with challenging skull characteristics and initial suboptimal outcomes, staged procedures may be considered, with potential delayed benefits and the need for lesion expansion for long-term relief.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"15 ","pages":"406"},"PeriodicalIF":0.0000,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618826/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Surgical neurology international","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.25259/SNI_707_2024","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
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Abstract
Background: Magnetic resonance imaging-guided focused ultrasound (MRgFUS) thalamotomy offers incisionless treatment for essential tremor or tremor-dominant Parkinson's disease, gaining acceptance as an alternative to deep brain stimulation. Compared to other methods, it offers real-time efficacy assessment without ionizing radiation.
Case description: A 63-year-old male underwent MRgFUS, initially yielding subtle results due to skull limitations. However, significant tremor relief emerged 6 hours post-procedure, sustained for 5 days. Imaging confirmed thalamotomy effect. A second treatment was delivered at day five for longevity.
Conclusion: For patients with challenging skull characteristics and initial suboptimal outcomes, staged procedures may be considered, with potential delayed benefits and the need for lesion expansion for long-term relief.
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