Rinsho Shinkeigaku (Clinical Neurology)

Brief Clinical Note

Successful treatment with bilateral deep brain stimulation of the subthalamic nucleus for benign tremulous parkinsonism

Jiro Fukae, M.D.1)2), Chikashi Fukaya, M.D.3), Hideki Oshima, M.D.3), Kenji Ishii, M.D.4), Yoshio Tsuboi, M.D.2), Yoichi Katayama, M.D.3) and Nobutaka Hattori, M.D.1)

1)Departments of Neurology, Juntendo University School of Medicine
2)Departments of Neurology, Fukuoka University
3)Departments of Neurosurgery and Division of Applied system Neuroscience, Nihon University School of Medicine
4)Diagnostic Neuroimaging Research, Tokyo Metropolitan Institute of Gerontology

A 62-year-old man complained of resting tremor and posture tremor. In spite of presence of the tremor, other parkinsonian component was very mild. [11C]2β-carbomethoxy-3β-(4-fluorophenyl)-tropane ([11C]CFT) PET showed asymmetrical reduction of the uptake and [11C]raclopride PET showed slightly increased uptake in the striatum. Although he was diagnosed as having benign tremulous parkinsonism (BTP), anti-parkinsonian medications, including anti-cholinergic agent, dopamine agonist and L-dopa, were not effective for his tremor. His tremor gradually deteriorated enough to disturb writing, working, and eating. Because his quality of life (QOL) was disturbed by the troublesome tremor, deep brain stimulation of the subthalamic nucleus (STN-DBS) was performed. After STN-DBS, his tremor was dramatically improved. According to clinical course of our patient as well as previous reports, STN-DBS should be considered as a therapeutic option for BTP patients with severe tremor.
Full Text of this Article in Japanese PDF (3031K)

(CLINICA NEUROL, 54: 511|514, 2014)
key words: benign tremulous parkinsonism, tremor, deep brain stimulation, PET

(Received: 30-Apr-13)