Progressive Multifocal Encephalopathy Holmes Tremor Successfully Treated with Bilateral Deep Brain Stimulation

Tremor Other Hyperkinet Mov (N Y). 2023 Sep 1:13:31. doi: 10.5334/tohm.781. eCollection 2023.

Abstract

Background: We report a patient with bilateral HT treated with DBS.

Case report: A 58-year-old man diagnosed with HIV/AIDS and progressive multifocal leukoencephalopathy (PML) presented with 20 years of bilateral arm tremor refractory to therapy. DBS was implanted on the left ventral intermediate nucleus and posterior subthalamic area (VIM/PSA). One year later, a right VIM/PSA DBS was implanted. At twelve months, there were no significant side-effects. With his DBS turned off and on, the Fahn-Tolosa-Marin scale was rated 82 and 58, respectively.

Discussion: To our knowledge, this is the first report of bilateral DBS VIM/PSA treating HT with no significant side effects.

Highlights: We report a successful treatment using deep brain stimulation of bilateral Holmes tremor that was caused by progressive multifocal encephalopathy. The patient achieved 30% improvement in tremor control with a meaningful improvement in his activities of daily living.

Keywords: Deep brain Stimulation; Homes tremor; Rubral Tremor; Tremor.

Publication types

  • Case Reports

MeSH terms

  • Activities of Daily Living
  • Brain Diseases*
  • Deep Brain Stimulation*
  • Humans
  • Male
  • Middle Aged
  • Prostate-Specific Antigen
  • Tremor / therapy

Substances

  • Prostate-Specific Antigen