PDF(Pubmed)
Abstract：
UNASSIGNED: A 63-year-old man with severe essential tremor underwent staged bilateral ventralis intermedius (Vim) deep brain stimulation (DBS). Left Vim DBS resulted in improved right upper extremity tremor control. Months later, the addition of right Vim DBS to the other brain hemisphere was associated with acute worsening of the right upper extremity tremor.
UNASSIGNED: In staged bilateral Vim DBS, second lead implantation may possibly alter ipsilateral tremor control. While ipsilateral improvement is common, rarely, it can disrupt previously achieved benefit.
UNASSIGNED: DBS programming, including an increase in left Vim DBS amplitude, re-established and enhanced bilateral tremor control.
UNASSIGNED: The mechanisms underlying changes in ipsilateral tremor control following a second lead implantation are unknown. In this case, worsening and subsequent improvement after optimization highlight the potential impact of DBS implantation on the ipsilateral side.
UNASSIGNED: After staged bilateral Vim DBS, clinicians should keep an eye on the first or original DBS side and carefully monitor for emergent side effects or worsening in tremor. Ipsilateral effects resulting from DBS implantation present a reprogramming opportunity with a potential to further optimize clinical outcomes.
UNASSIGNED: This case report highlights the potential for ipsilateral tremor worsening following staged bilateral DBS and provides valuable insights into troubleshooting and reprogramming strategies. The report emphasizes the importance of vigilant monitoring and individualized management in optimizing clinical outcomes for patients undergoing staged bilateral DBS for essential tremor.
UNASSIGNED: In staged bilateral Vim DBS, second lead implantation may possibly alter ipsilateral tremor control. While ipsilateral improvement is common, rarely, it can disrupt previously achieved benefit.
UNASSIGNED: DBS programming, including an increase in left Vim DBS amplitude, re-established and enhanced bilateral tremor control.
UNASSIGNED: The mechanisms underlying changes in ipsilateral tremor control following a second lead implantation are unknown. In this case, worsening and subsequent improvement after optimization highlight the potential impact of DBS implantation on the ipsilateral side.
UNASSIGNED: After staged bilateral Vim DBS, clinicians should keep an eye on the first or original DBS side and carefully monitor for emergent side effects or worsening in tremor. Ipsilateral effects resulting from DBS implantation present a reprogramming opportunity with a potential to further optimize clinical outcomes.
UNASSIGNED: This case report highlights the potential for ipsilateral tremor worsening following staged bilateral DBS and provides valuable insights into troubleshooting and reprogramming strategies. The report emphasizes the importance of vigilant monitoring and individualized management in optimizing clinical outcomes for patients undergoing staged bilateral DBS for essential tremor.
摘要：
■一名患有严重特发性震颤的63岁男子接受了阶段性的双侧腹侧（Vim）深部脑刺激（DBS）。左VimDBS改善了右上肢震颤控制。几个月后,右脑半球增加VimDBS与右上肢震颤急性恶化相关。
■在上演的双边VimDBS中，第二导联植入可能改变同侧震颤控制。虽然同侧改善很常见，很少,它可以破坏以前获得的利益。
■DBS编程，包括左VimDBS振幅的增加，重建并加强双侧震颤控制。
■第二根导线植入后同侧震颤控制变化的潜在机制尚不清楚。在这种情况下,优化后的恶化和随后的改善凸显了DBS植入对同侧的潜在影响.
■在上演双边VimDBS之后，临床医生应密切关注DBS的第一侧或原始侧，并仔细监测出现的副作用或震颤恶化。由DBS植入引起的同侧效应提供了重新编程的机会,具有进一步优化临床结果的潜力。
■本病例报告强调了双侧DBS分期后同侧震颤恶化的可能性，并提供了对故障排除和重新编程策略的宝贵见解。该报告强调了警惕监测和个性化管理在优化因特发性震颤而接受分期双侧DBS的患者的临床结果方面的重要性。
■在上演的双边VimDBS中，第二导联植入可能改变同侧震颤控制。虽然同侧改善很常见，很少,它可以破坏以前获得的利益。
■DBS编程，包括左VimDBS振幅的增加，重建并加强双侧震颤控制。
■第二根导线植入后同侧震颤控制变化的潜在机制尚不清楚。在这种情况下,优化后的恶化和随后的改善凸显了DBS植入对同侧的潜在影响.
■在上演双边VimDBS之后，临床医生应密切关注DBS的第一侧或原始侧，并仔细监测出现的副作用或震颤恶化。由DBS植入引起的同侧效应提供了重新编程的机会,具有进一步优化临床结果的潜力。
■本病例报告强调了双侧DBS分期后同侧震颤恶化的可能性，并提供了对故障排除和重新编程策略的宝贵见解。该报告强调了警惕监测和个性化管理在优化因特发性震颤而接受分期双侧DBS的患者的临床结果方面的重要性。
