Tremor Associated With Klinefelter Syndrome: Report of a Case Treated by Deep Brain Stimulation and Systematic Review of the Literature.

IF 3.2 3区 医学 Q2 CLINICAL NEUROLOGY
Baraa Dabboucy, Reza Hazrati, Melanie Langlois, Michel Prudhomme
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引用次数: 0

Abstract

Introduction: Klinefelter syndrome (KS) is a sex chromosome-related genetic disease that commonly affects male subjects with infertility. Small testes, gynecomastia, infertility, and possible developmental abnormalities are symptoms of this condition. According to recent studies, people with KS also may have other neurologic problems, particularly tremors resembling essential tremors. Our review attempts to explore the features of tremors and their treatment in individuals with KS using case studies and previously published research.

Materials and methods: A PubMed/Medline search was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines using the following MeSH terms: ("Tremor") AND ("Klinefelter syndrome") OR ("Tremor") AND ("associated") AND ("Klinefelter syndrome") OR ("Tremor") AND ("hypogonadism"). The review included 24 articles.

Results: The average age at tremor onset was 15.59 years, and the most prevalent tremor types (31.91% of cases) were a combination of postural and kinetic/intention tremors. Overall, 40% of patients exhibited some improvement; 10% showed significant improvement, and 50% showed no impact when antitremor medications were administered. Testosterone replacement therapy is not a suitable option for this symptom because the effects of testosterone treatment on tremors are inconsistent. In each of the three described cases, tremors were significantly relieved after deep brain stimulation (DBS) surgery of the ventral intermediate nucleus (VIM). We also report a case of a man aged 54 years with KS who was unable to perform his regular tasks owing to severe tremors. His tremor was well managed with bilateral DBS of the thalamic VIM nucleus.

Conclusion: Tremors are a potentially disabling associated manifestation of KS. The available literature on the management of tremors in patients with KS is limited. Surgical VIM-DBS has shown promising results in managing medication-refractory tremors in patients with KS, with an acceptable safety profile. Further research is needed to determine the causes of tremors in KS and to optimize treatment.

Klinefelter综合征伴震颤:深部脑刺激治疗1例报告及文献系统复习。
简介:Klinefelter综合征(KS)是一种与性染色体相关的遗传性疾病,常见于男性不育患者。睾丸小、男性乳房畸形、不育和可能的发育异常都是这种情况的症状。根据最近的研究,患有KS的人还可能有其他神经系统问题,特别是类似于原发性震颤的震颤。我们的综述试图通过案例研究和先前发表的研究来探讨震颤的特征及其在KS患者中的治疗。材料和方法:根据系统评价和荟萃分析指南的首选报告项目进行PubMed/Medline搜索,使用以下MeSH术语:(震颤)和(Klinefelter综合征)或(震颤)和(相关)和(Klinefelter综合征)或(震颤)和(性腺功能减退)。该综述包括24篇文章。结果:震颤发作的平均年龄为15.59岁,最常见的震颤类型为体位性震颤和动力/意向性震颤,占31.91%。总体而言,40%的患者表现出一定的改善;10%的人表现出明显的改善,50%的人在服用抗震颤药物后没有表现出任何影响。睾酮替代疗法不是治疗这种症状的合适选择,因为睾酮治疗对震颤的效果不一致。在上述三个病例中,震颤均在腹侧中间核(VIM)深部脑刺激(DBS)手术后得到显著缓解。我们也报告一个54岁的男子与KS谁是无法执行他的日常工作,由于严重的震颤。他的震颤通过双侧丘脑VIM核的DBS得到了很好的控制。结论:震颤是KS的潜在致残相关表现。有关KS患者震颤治疗的文献是有限的。手术VIM-DBS在治疗KS患者的药物难治性震颤方面显示出有希望的结果,具有可接受的安全性。需要进一步的研究来确定KS中震颤的原因并优化治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Neuromodulation
Neuromodulation 医学-临床神经学
CiteScore
6.40
自引率
3.60%
发文量
978
审稿时长
54 days
期刊介绍: Neuromodulation: Technology at the Neural Interface is the preeminent journal in the area of neuromodulation, providing our readership with the state of the art clinical, translational, and basic science research in the field. For clinicians, engineers, scientists and members of the biotechnology industry alike, Neuromodulation provides timely and rigorously peer-reviewed articles on the technology, science, and clinical application of devices that interface with the nervous system to treat disease and improve function.
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