• J. Neurol. Neurosurg. Psychiatr. · Apr 2022

    Functional tremor developing after successful MRI-guided focused ultrasound thalamotomy for essential tremor.

    • Sohaila Alshimemeri, Daniel Vargas-Méndez, Robert Chen, Nir Lipsman, M L Schwartz, Andres M Lozano, and Alfonso Fasano.
    • Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, UHN, Toronto Western Hospital, Toronto, Ontario, Canada.
    • J. Neurol. Neurosurg. Psychiatr. 2022 Apr 26.

    ObjectiveTo describe a case of functional tremor occurring after a successful MR-guided focused ultrasound thalamotomy (MRgFUS) for essential tremor.MethodsA 71-year-old right-handed man with essential tremor was referred to us for consideration of deep brain stimulation surgery for worsening bilateral upper limb tremor after a successful left MRgFUS for essential tremor.ResultsOn clinical exam, signs compatible with a functional tremor were noted, including entertainability and suppressibility. Electrophysiological studies were consistent with essential tremor and superimposed tremor fulfilling the laboratory-supported criteria for functional tremor.DiscussionWe describe the first reported case of a functional movement disorder occurring after successful MRgFUS procedure for essential tremor. Recognising this entity and its development after such therapeutic interventions is essential to avoid further unnecessary invasive therapies.© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.

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