Is Transcranial Magnetic Resonance Imaging-Guided Focused Ultrasound a Repeatable Treatment Option? Case Report of a Retreated Patient With Tremor Combined With Parkinsonism

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Abstract

INTRODUCTION:In recent years, transcranial Magnetic Resonance Imaging-guidedFocused Ultrasound (tcMRgFUS) treatments for functional neurological disorders aregiving a new thrust to the field of therapeutic brain lesioning.OBJECTIVE:To present the case of a patient affected by tremor combined with Parkin-sonism who underwent a second tcMRgFUS thalamotomy because of relapsing tremorafter a few months from the first tcMRgFUS treatment.METHODS:A 72-yr-old, right-handed man, came to our observation because of a disablingtremor affecting his upper limbs, refusing any invasive surgical procedure and alreadytreated by tcMRgFUS left Vim thalamotomy. However, clinical benefit had brief duration,as a progressive recurrence of tremor on the right upper limb was observed after a fewmonths from the first treatment. Thus, the patient underwent a new left-sided tcMRgFUSprocedure 6 mo after the former treatment.RESULTS:After the second procedure, an immediate and complete relief from tremoron the right upper limb was achieved with clinical benefit that persisted up to a 6-mofollow-up.CONCLUSION:Since tcMRgFUS doesn’t use ionizing radiations and it is incision-less,repeated and staged treatment procedures have always been hypothesized. Our reportsuggests that tcMRgFUS retreatment might actually be a feasible, safe, and effective optionin selected patients in whom an optimal clinical outcome is not achieved after the firsttreatment session. However, future well-designed studies in large samples are needed toassess the possible risks of retreatment and the optimal timing of reintervention as well aseligibility and exclusion criteria.
Lingua originaleEnglish
Numero di pagine6
RivistaOperative Neurosurgery
Stato di pubblicazionePublished - 2019

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

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