Essential tremor leading to toxic liver damage successfully treated with deep brain stimulation

Acta Neurochir (Wien). 2009 Oct;151(10):1305-7. doi: 10.1007/s00701-009-0249-x. Epub 2009 Mar 17.

Abstract

Purpose: We present a patient with severe essential tremor (ET), who underwent thalamic deep brain stimulation (DBS). After previous medical treatment with Propranolol and Primidone failed, the patient resorted to alcohol, which greatly alleviated the symptoms. The downside of this situation, however, was that it led to alcoholism with severely disturbed liver enzymes and hepatic steatosis.

Methods & results: After DBS the patient was free of tremor and thus could easily abstain from alcohol.

Conclusion: In time the elevated liver enzymes returned to normal, which indicates that sufficient tremor control by DBS can help these patients to abstain from alcohol.

Publication types

  • Case Reports

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • Aged
  • Alcoholism / complications*
  • Alcoholism / etiology
  • Anticonvulsants / therapeutic use
  • Central Nervous System Depressants / adverse effects*
  • Central Nervous System Depressants / therapeutic use
  • Deep Brain Stimulation / methods*
  • Essential Tremor / physiopathology
  • Essential Tremor / therapy*
  • Ethanol / adverse effects*
  • Ethanol / therapeutic use
  • Humans
  • Liver / diagnostic imaging
  • Liver / drug effects
  • Liver / physiopathology
  • Liver Diseases, Alcoholic / pathology
  • Liver Diseases, Alcoholic / physiopathology*
  • Male
  • Neural Pathways / physiology
  • Neurosurgical Procedures
  • Primidone / therapeutic use
  • Propranolol / therapeutic use
  • Stereotaxic Techniques
  • Treatment Failure
  • Treatment Outcome
  • Ultrasonography
  • Ventral Thalamic Nuclei / anatomy & histology
  • Ventral Thalamic Nuclei / physiology
  • Ventral Thalamic Nuclei / surgery

Substances

  • Adrenergic beta-Antagonists
  • Anticonvulsants
  • Central Nervous System Depressants
  • Primidone
  • Ethanol
  • Propranolol