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[PMID]: 29360867 [Au] Autor: Mücke D; Hermes A; Roettger TB; Becker J; Niemann H; Dembek TA; Timmermann L; Visser-Vandewalle V; Fink GR; Grice M; Barbe MT [Ad] Endereço: IfL-Phonetics, University of Cologne, Cologne, Germany. [Ti] Título: The effects of Thalamic Deep Brain Stimulation on speech dynamics in patients with Essential Tremor: An articulographic study. [So] Source: PLoS One;13(1):e0191359, 2018. [Is] ISSN: 1932-6203 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Acoustic studies have revealed that patients with Essential Tremor treated with thalamic Deep Brain Stimulation (DBS) may suffer from speech deterioration in terms of imprecise oral articulation and reduced voicing control. Based on the acoustic signal one cannot infer, however, whether this deterioration is due to a general slowing down of the speech motor system (e.g., a target undershoot of a desired articulatory goal resulting from being too slow) or disturbed coordination (e.g., a target undershoot caused by problems with the relative phasing of articulatory movements). To elucidate this issue further, we here investigated both acoustics and articulatory patterns of the labial and lingual system using Electromagnetic Articulography (EMA) in twelve Essential Tremor patients treated with thalamic DBS and twelve age- and sex-matched controls. By comparing patients with activated (DBS-ON) and inactivated stimulation (DBS-OFF) with control speakers, we show that critical changes in speech dynamics occur on two levels: With inactivated stimulation (DBS-OFF), patients showed coordination problems of the labial and lingual system in terms of articulatory imprecision and slowness. These effects of articulatory discoordination worsened under activated stimulation, accompanied by an additional overall slowing down of the speech motor system. This leads to a poor performance of syllables on the acoustic surface, reflecting an aggravation either of pre-existing cerebellar deficits and/or the affection of the upper motor fibers of the internal capsule. [Mh] Termos MeSH primário: Transtornos da Articulação/etiologia Estimulação Encefálica Profunda/efeitos adversos Tremor Essencial/terapia Tálamo/fisiopatologia [Mh] Termos MeSH secundário: Adulto Idoso Transtornos da Articulação/fisiopatologia Transtornos da Articulação/psicologia Estudos de Casos e Controles Tremor Essencial/fisiopatologia Tremor Essencial/psicologia Feminino Seres Humanos Masculino Meia-Idade Fala/fisiologia Acústica da Fala Testes de Articulação da Fala [Pt] Tipo de publicação: JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180227 [Lr] Data última revisão: 180227 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 180124 [St] Status: MEDLINE [do] DOI: 10.1371/journal.pone.0191359

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[PMID]: 28471567 [Au] Autor: Yaghmour NE; Israel Z; Bergman H; Eitan R; Arkadir D [Ad] Endereço: Department of Neurology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel. [Ti] Título: Deep Brain Stimulation in Parkinson's Disease and Essential Tremor: In Search of Lost Time. [So] Source: Isr Med Assoc J;18(7):424-425, 2016 Jul. [Is] ISSN: 1565-1088 [Cp] País de publicação: Israel [La] Idioma: eng [Mh] Termos MeSH primário: Estimulação Encefálica Profunda/métodos Tremor Essencial/terapia Doença de Parkinson/terapia [Mh] Termos MeSH secundário: Tremor Essencial/fisiopatologia Seres Humanos Doença de Parkinson/fisiopatologia Fatores de Tempo [Pt] Tipo de publicação: EDITORIAL [Em] Mês de entrada: 1711 [Cu] Atualização por classe: 171128 [Lr] Data última revisão: 171128 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170505 [St] Status: MEDLINE

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[PMID]: 28471558 [Au] Autor: Kestenbaum M; Robakis D; Ford B; Alcalay RN; Louis ED [Ad] Endereço: Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA. [Ti] Título: Clinical Characteristics of Patients with Parkinson's Disease and Essential Tremor Undergoing Deep Brain Stimulation Surgery at Columbia University Medical Center (2009-2014). [So] Source: Isr Med Assoc J;18(7):386-390, 2016 Jul. [Is] ISSN: 1565-1088 [Cp] País de publicação: Israel [La] Idioma: eng [Mh] Termos MeSH primário: Estimulação Encefálica Profunda/métodos Tremor Essencial/cirurgia Doença de Parkinson/cirurgia Seleção de Pacientes [Mh] Termos MeSH secundário: Centros Médicos Acadêmicos Idade de Início Idoso Idoso de 80 Anos ou mais Registros Eletrônicos de Saúde Tremor Essencial/fisiopatologia Feminino Seres Humanos Masculino Meia-Idade Doença de Parkinson/fisiopatologia Encaminhamento e Consulta Estudos Retrospectivos Resultado do Tratamento [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1711 [Cu] Atualização por classe: 171128 [Lr] Data última revisão: 171128 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170505 [St] Status: MEDLINE

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[PMID]: 28957367 [Au] Autor: Kang N; Cauraugh JH [Ad] Endereço: Laboratory for Rehabilitation Neuroscience, Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida, United States of America. [Ti] Título: Does non-invasive brain stimulation reduce essential tremor? A systematic review and meta-analysis. [So] Source: PLoS One;12(9):e0185462, 2017. [Is] ISSN: 1932-6203 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Essential tremor (ET) is the most common age-related disease leading to abnormal tremulous behaviors in the upper and lower extremities. Non-invasive brain stimulation (NIBS) may be an effective ET therapy by modulating the oscillating network of the brain. The current systematic review and meta-analysis examined the effects of NIBS interventions on tremor symptoms in ET patients. Our comprehensive search identified eight studies that used 1 Hz of rTMS, cTBS, or ctDCS protocols. Twenty total comparisons from the eight qualified studies were statistically synthesized, and the meta-analytic findings revealed that NIBS techniques reduced tremulous behaviors in individuals with ET. Moreover, the four moderator variable analyses demonstrated that the positive therapeutic effects of NIBS appeared across the following subgroups: (a) tremor assessment (clinical test vs. quantitative tremor assessment), (b) stimulation site (cerebellum vs. motor cortex), (c) session number (single session vs. multiple sessions), and (d) sustained positive treatment effect (posttest vs. retention test). This comprehensive systematic review and meta-analysis provided evidence that support positive treatment effects of NIBS techniques on ET motor therapy. [Mh] Termos MeSH primário: Encéfalo/patologia Terapia por Estimulação Elétrica Tremor Essencial/terapia Estimulação Magnética Transcraniana [Mh] Termos MeSH secundário: Adulto Idoso Demografia Feminino Heterogeneidade Genética Seres Humanos Masculino Meia-Idade Viés de Publicação [Pt] Tipo de publicação: JOURNAL ARTICLE; META-ANALYSIS; REVIEW [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171018 [Lr] Data última revisão: 171018 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170929 [St] Status: MEDLINE [do] DOI: 10.1371/journal.pone.0185462

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[PMID]: 28870357 [Au] Autor: Edwards CA; Kouzani A; Lee KH; Ross EK [Ad] Endereço: School of Engineering, Deakin University, Geelong, Victoria, Australia; Department of Neurologic Surgery, Mayo Clinic, Rochester, MN. [Ti] Título: Neurostimulation Devices for the Treatment of Neurologic Disorders. [So] Source: Mayo Clin Proc;92(9):1427-1444, 2017 Sep. [Is] ISSN: 1942-5546 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: Rapid advancements in neurostimulation technologies are providing relief to an unprecedented number of patients affected by debilitating neurologic and psychiatric disorders. Neurostimulation therapies include invasive and noninvasive approaches that involve the application of electrical stimulation to drive neural function within a circuit. This review focuses on established invasive electrical stimulation systems used clinically to induce therapeutic neuromodulation of dysfunctional neural circuitry. These implantable neurostimulation systems target specific deep subcortical, cortical, spinal, cranial, and peripheral nerve structures to modulate neuronal activity, providing therapeutic effects for a myriad of neuropsychiatric disorders. Recent advances in neurotechnologies and neuroimaging, along with an increased understanding of neurocircuitry, are factors contributing to the rapid rise in the use of neurostimulation therapies to treat an increasingly wide range of neurologic and psychiatric disorders. Electrical stimulation technologies are evolving after remaining fairly stagnant for the past 30 years, moving toward potential closed-loop therapeutic control systems with the ability to deliver stimulation with higher spatial resolution to provide continuous customized neuromodulation for optimal clinical outcomes. Even so, there is still much to be learned about disease pathogenesis of these neurodegenerative and psychiatric disorders and the latent mechanisms of neurostimulation that provide therapeutic relief. This review provides an overview of the increasingly common stimulation systems, their clinical indications, and enabling technologies. [Mh] Termos MeSH primário: Terapia por Estimulação Elétrica/métodos Transtornos Mentais/terapia Doenças do Sistema Nervoso/terapia Recuperação de Função Fisiológica/fisiologia [Mh] Termos MeSH secundário: Estimulação Encefálica Profunda/instrumentação Estimulação Encefálica Profunda/métodos Estimulação Encefálica Profunda/normas Distonia/terapia Terapia por Estimulação Elétrica/instrumentação Terapia por Estimulação Elétrica/normas Epilepsia/terapia Tremor Essencial/terapia Seres Humanos Neuroestimuladores Implantáveis/normas Transtorno Obsessivo-Compulsivo/terapia Doença de Parkinson/terapia Estimulação da Medula Espinal/instrumentação Estimulação da Medula Espinal/métodos Estimulação da Medula Espinal/normas Estimulação do Nervo Vago/instrumentação Estimulação do Nervo Vago/métodos Estimulação do Nervo Vago/normas [Pt] Tipo de publicação: JOURNAL ARTICLE; REVIEW [Em] Mês de entrada: 1709 [Cu] Atualização por classe: 170913 [Lr] Data última revisão: 170913 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 170906 [St] Status: MEDLINE

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[PMID]: 28841694 [Au] Autor: Barrantes S; Sánchez Egea AJ; González Rojas HA; Martí MJ; Compta Y; Valldeoriola F; Simo Mezquita E; Tolosa E; Valls-Solè J [Ad] Endereço: School of Medicine, University of Barcelona (UB). Barcelona, Catalonia, Spain. [Ti] Título: Differential diagnosis between Parkinson's disease and essential tremor using the smartphone's accelerometer. [So] Source: PLoS One;12(8):e0183843, 2017. [Is] ISSN: 1932-6203 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: The differential diagnosis between patients with essential tremor (ET) and those with Parkinson's disease (PD) whose main manifestation is tremor may be difficult unless using complex neuroimaging techniques such as 123I-FP-CIT SPECT. We considered that using smartphone's accelerometer to stablish a diagnostic test based on time-frequency differences between PD an ET could support the clinical diagnosis. METHODS: The study was carried out in 17 patients with PD, 16 patients with ET, 12 healthy volunteers and 7 patients with tremor of undecided diagnosis (TUD), who were re-evaluated one year after the first visit to reach the definite diagnosis. The smartphone was placed over the hand dorsum to record epochs of 30 s at rest and 30 s during arm stretching. We generated frequency power spectra and calculated receiver operating characteristics curves (ROC) curves of total spectral power, to establish a threshold to separate subjects with and without tremor. In patients with PD and ET, we found that the ROC curve of relative energy was the feature discriminating better between the two groups. This threshold was then used to classify the TUD patients. RESULTS: We could correctly classify 49 out of 52 subjects in the category with/without tremor (97.96% sensitivity and 83.3% specificity) and 27 out of 32 patients in the category PD/ET (84.38% discrimination accuracy). Among TUD patients, 2 of 2 PD and 2 of 4 ET were correctly classified, and one patient having PD plus ET was classified as PD. CONCLUSIONS: Based on the analysis of smartphone accelerometer recordings, we found several kinematic features in the analysis of tremor that distinguished first between healthy subjects and patients and, ultimately, between PD and ET patients. The proposed method can give immediate results for the clinician to gain valuable information for the diagnosis of tremor. This can be useful in environments where more sophisticated diagnostic techniques are unavailable. [Mh] Termos MeSH primário: Acelerometria/instrumentação Tremor Essencial/diagnóstico Doença de Parkinson/diagnóstico Smartphone [Mh] Termos MeSH secundário: Estudos de Casos e Controles Diagnóstico Diferencial Seres Humanos Estudos Prospectivos [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171026 [Lr] Data última revisão: 171026 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170826 [St] Status: MEDLINE [do] DOI: 10.1371/journal.pone.0183843

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MEDLINE

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[PMID]: 28836659 [Au] Autor: Bruno E; Nicoletti A; Filippini G; Quattrocchi G; Colosimo C; Zappia M [Ad] Endereço: Department GF Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy, 95123. [Ti] Título: Zonisamide for essential tremor. [So] Source: Cochrane Database Syst Rev;8:CD009684, 2017 08 24. [Is] ISSN: 1469-493X [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: BACKGROUND: Essential tremor (ET) is one of the most common movement disorders. The treatment is primarily based on pharmacological agents. Although primidone and propranolol are well established treatments in clinical practice, they can be ineffective in 25% to 55% of patients, and can produce serious adverse events in a large percentage of them. For these reasons, it may be worthwhile evaluating the treatment alternatives for ET. Zonisamide has been suggested as a potentially useful agent for the treatment of ET but there is uncertainty about its efficacy and safety. OBJECTIVES: To assess the effect on functional abilities and the safety profile of zonisamide in adults with essential tremor (ET). SEARCH METHODS: We carried out a systematic search, without language restrictions to identify all relevant trials. We searched CENTRAL, MEDLINE, Embase, NICE, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform (ICTRP) to January 2017. We searched BIOSIS Citation Index (2000 to January 2017) for conference proceedings. We handsearched grey literature and examined the reference lists of identified studies and reviews. SELECTION CRITERIA: We included all randomised controlled trials (RCTs) of zonisamide versus placebo or any other treatment. We included studies in which the diagnosis of ET was made according to accepted and validated diagnostic criteria. We excluded studies conducted in patients presenting secondary forms of tremor or reporting only neurophysiological parameters to assess outcomes. DATA COLLECTION AND ANALYSIS: Two review authors independently collected and extracted data using a data collection form. We assessed the risk of bias and the quality of evidence.We used inverse variance methods for continuous outcomes and measurement scales. We compared differences between treatment groups as mean differences. We combined results for dichotomous outcomes using Mantel-Haenszel methods and obtained risk differences to compare treatment groups. We used Review Manager 5 software for data management and analysis. MAIN RESULTS: We only considered one study eligible for this review (20 participants). Assessments of risk of bias for most domains were unclear or low. Adverse events were only reported in participants from the zonisamide group, making it possible that they were aware of treatment group assignment. We are uncertain as to the effects of zonisamide on motor tasks (mean difference (MD) -0.00, 95% confidence interval (CI) -1.51 to 1.51, very low-quality evidence) and functional disabilities (MD -0.30, 95% CI -1.23 to 0.63, very low-quality evidence) when compared with placebo. Three participants in the zonisamide group (30%) and two participants in the placebo group (20%) discontinued the treatment and withdrew from the study for any reason (very low-quality evidence), however the increased risk of withdrawal in the zonisamide group was statistically non-significant (risk difference (RD) 0.1, 95% CI -0.28 to 0.48). Six participants in the zonisamide group (60%) and none of the participants in the placebo group (0%) developed adverse events (AEs), with a RD of 0.60 (95% CI 0.28 to 0.92; very low quality evidence). The most common AEs, experienced with zonisamide treatment, were headache, nausea, fatigue, sleepiness, and diarrhoea. Quality of life was not assessed in the study included. AUTHORS' CONCLUSIONS: Based on currently available data, there is insufficient evidence to assess the efficacy and safety of zonisamide treatment for ET. [Mh] Termos MeSH primário: Anticonvulsivantes/uso terapêutico Tremor Essencial/tratamento farmacológico Isoxazóis/uso terapêutico [Mh] Termos MeSH secundário: Anticonvulsivantes/efeitos adversos Seres Humanos Isoxazóis/efeitos adversos Ensaios Clínicos Controlados Aleatórios como Assunto [Pt] Tipo de publicação: JOURNAL ARTICLE; REVIEW [Nm] Nome de substância: 0 (Anticonvulsants); 0 (Isoxazoles); 459384H98V (zonisamide) [Em] Mês de entrada: 1709 [Cu] Atualização por classe: 170920 [Lr] Data última revisão: 170920 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170825 [St] Status: MEDLINE [do] DOI: 10.1002/14651858.CD009684.pub2

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[PMID]: 28832787 [Au] Autor: Azevedo MFA; Meyer A [Ad] Endereço: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil. [Ti] Título: [Essential tremor in endemic disease control agents exposed to pesticides: a case-control study]. [Ti] Título: Tremor essencial em guardas de endemias expostos a agrotóxicos: estudo caso-controle.. [So] Source: Cad Saude Publica;33(8):e00194915, 2017 Aug 21. [Is] ISSN: 1678-4464 [Cp] País de publicação: Brazil [La] Idioma: por [Ab] Resumo: Tremor is the most frequent movement disorder in the population and can be associated with pesticide exposure. The aim was to assess the odds of essential tremor in 442 endemic disease control agents in Rio de Janeiro State, Brazil, exposed to pesticides. Fifty-one cases and 204 controls were selected (1:4). All participants answered a questionnaire on socio-demographic, occupational, and toxicological items. The influence of pesticide exposure on the development of tremor was estimated by non-conditional logistic regression, adjusted for selected covariables. Mean age of the study population was 49 (SD = 7) years, and the difference between cases (mean = 50.8; SD = 6.9) and controls (mean = 48.5; SD = 6.9) was statistically significant (p = 0.03). Those with 16 to 16.9 years of pesticide use showed the highest odds of essential tremor (adjusted OR = 4.60; 95%CI: 1.29-16.41). Our results suggest that 16 to 16.9 years of pesticide exposure had a major impact on the development of essential tremor. [Mh] Termos MeSH primário: Tremor Essencial/induzido quimicamente Exposição Ocupacional/efeitos adversos Praguicidas/toxicidade [Mh] Termos MeSH secundário: Brasil Estudos de Casos e Controles Doenças Endêmicas Feminino Seres Humanos Modelos Logísticos Masculino Meia-Idade Inquéritos e Questionários Fatores de Tempo [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Pesticides) [Em] Mês de entrada: 1711 [Cu] Atualização por classe: 171106 [Lr] Data última revisão: 171106 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170824 [St] Status: MEDLINE

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[PMID]: 28822302 [Au] Autor: Legrand AP; Rivals I; Richard A; Apartis E; Roze E; Vidailhet M; Meunier S; Hainque E [Ad] Endereço: ESPCI Paris, PSL Research University, Paris, France. Electronic address: andre-pierre.legrand@espci.fr. [Ti] Título: New insight in spiral drawing analysis methods - Application to action tremor quantification. [So] Source: Clin Neurophysiol;128(10):1823-1834, 2017 Oct. [Is] ISSN: 1872-8952 [Cp] País de publicação: Netherlands [La] Idioma: eng [Ab] Resumo: OBJECTIVE: Spiral drawing is one of the standard tests used to assess tremor severity for the clinical evaluation of medical treatments. Tremor severity is estimated through visual rating of the drawings by movement disorders experts. Different approaches based on the mathematical signal analysis of the recorded spiral drawings were proposed to replace this rater dependent estimate. The objective of the present study is to propose new numerical methods and to evaluate them in terms of agreement with visual rating and reproducibility. METHODS: Series of spiral drawings of patients with essential tremor were visually rated by a board of experts. In addition to the usual velocity analysis, three new numerical methods were tested and compared, namely static and dynamic unraveling, and empirical mode decomposition. The reproducibility of both visual and numerical ratings was estimated, and their agreement was evaluated. RESULTS: The statistical analysis demonstrated excellent agreement between visual and numerical ratings, and more reproducible results with numerical methods than with visual ratings. CONCLUSIONS: The velocity method and the new numerical methods are in good agreement. Among the latter, static and dynamic unravelling both display a smaller dispersion and are easier for automatic analysis. SIGNIFICANCE: The reliable scores obtained through the proposed numerical methods allow considering that their implementation on a digitized tablet, be it connected with a computer or independent, provides an efficient automatic tool for tremor severity assessment. [Mh] Termos MeSH primário: Computadores de Mão Diagnóstico por Computador/métodos Tremor Essencial/diagnóstico Tremor Essencial/fisiopatologia Destreza Motora/fisiologia [Mh] Termos MeSH secundário: Adulto Idoso Computadores de Mão/normas Diagnóstico por Computador/normas Feminino Escrita Manual Seres Humanos Masculino Meia-Idade Reprodutibilidade dos Testes Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171003 [Lr] Data última revisão: 171003 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170820 [St] Status: MEDLINE

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[PMID]: 28817495 [Au] Autor: Shaw KD; Johnston AS; Rush-Evans S; Prather S; Maynard K [Ad] Endereço: Amy Sue Johnston, MSN AGCNS-BC CNRN, is Clinical Nurse Specialist, Neuroscience, University of Virginia Health System, Charlottesville, VA. Shelly Rush-Evans, MSN RN CNRN, is Staff Nurse, Neurosurgery, University of Virginia Health System, Charlottesville, VA. Susan Prather, MSN RN CNRN, is Nurse Manager, University of Virginia Health System, Charlottesville, VA. Kathy Maynard, ADN RN CNRN, is Nurse Coordinator, Neurosurgery, University of Virginia Health System, Charlottesville, VA. [Ti] Título: Nursing Management of the Patient Undergoing Focused Ultrasound: A New Treatment Option for Essential Tremor. [So] Source: J Neurosci Nurs;49(5):307-310, 2017 Oct. [Is] ISSN: 1945-2810 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Essential tremor (ET) is among the most common neurological movement disorders that causes postural or action tremors, with an estimated prevalence nationwide of less than 3% of the population. The incidence of ET increases with age but often affects younger adults and has a familial trait association. Depending on disease progression, ET can cause significant limitations for individuals, in many cases, significantly limiting their ability to perform activities of daily living and occupational responsibilities. Until recently, treatment of ET heavily relied on medication management and invasive surgery, such as deep brain stimulation. With advances in the use of focused ultrasound (FUS) for treatment of various medical conditions, recent clinical trials have revealed positive outcomes with the use of FUS as a less invasive approach to treat patients with medication-refractory ET. In a large academic medical center in the mid-Atlantic region, the Department of Neurosurgery conducted a continued access study, recently approved by the Food and Drug Administration, to evaluate the effectiveness of transcranial FUS thalamotomy for the treatment of medication-refractory ET. One patient's experience will be introduced, including discussion of evidence-based treatment options for ET and information on the nursing management of the patient undergoing FUS thalamotomy. [Mh] Termos MeSH primário: Tremor Essencial/cirurgia Enfermagem em Neurociência/métodos Procedimentos Neurocirúrgicos Terapia por Ultrassom/métodos [Mh] Termos MeSH secundário: Atividades Cotidianas Seres Humanos Masculino Resultado do Tratamento Núcleos Ventrais do Tálamo/cirurgia [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171031 [Lr] Data última revisão: 171031 [Sb] Subgrupo de revista: IM; N [Da] Data de entrada para processamento: 170818 [St] Status: MEDLINE [do] DOI: 10.1097/JNN.0000000000000301

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