Top

Acta Neurochirurgica

Published in:

01-10-2009 | Case Report

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

Authors: Johannes Levin, Jan Mehrkens, Alexander Gerbes, Kai Bötzel

Published in: Acta Neurochirurgica | Issue 10/2009

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.

Bain P, Brin M, Deuschl G, Elble R, Jankovic J, Findley L, Koller WC, Pahwa R (2000) Criteria for the diagnosis of essential tremor. Neurol 54:S7

Deuschl G, Bain P, Brin M (1998) Consensus statement of the Movement Disorder Society on Tremor. Ad Hoc Scientific Committee. Mov Disord 13(Suppl 3):2–23 doi:10.1002/mds.870130216

Jankovic J (2000) Essential tremor: clinical characteristics. Neurol 54:S21–S25

Klebe S, Stolze H, Grensing K, Volkmann J, Wenzelburger R, Deuschl G (2005) Influence of alcohol on gait in patients with essential tremor. Neurol 65:96–101 doi:10.1212/01.wnl.0000167550.97413.1f CrossRef

Hess CW, Saunders-Pullman R (2006) Movement disorders and alcohol misuse. Addict Biol 11:117–125 doi:10.1111/j.1369-1600.2006.00017.x CrossRefPubMed

Koller WC, Royse VL (1986) Efficacy of primidone in essential tremor. Neurology 36:121–124PubMed

Marsden CD, Jefferson D, Leigh N, Jenner P (1982) Plasma propranolol in essential tremor. Ann Neurol 11:107 doi:10.1002/ana.410110124 CrossRefPubMed

Ondo W, Almaguer M, Jankovic J, Simpson RK (2001) Thalamic deep brain stimulation: comparison between unilateral and bilateral placement. Arch Neurol 58:218–222 doi:10.1001/archneur.58.2.218 CrossRefPubMed

Schuurman PR, Bosch DA, Bossuyt PM, Bonsel GJ, van Someren EJ, de Bie RM, Merkus MP, Speelman JD (2000) A comparison of continuous thalamic stimulation and thalamotomy for suppression of severe tremor. N Engl J Med 342:461–468 doi:10.1056/NEJM200002173420703 CrossRefPubMed

Title: Essential tremor leading to toxic liver damage successfully treated with deep brain stimulation
Authors: Johannes Levin
Jan Mehrkens
Alexander Gerbes
Kai Bötzel
Publication date: 01-10-2009
Publisher: Springer Vienna
Published in: Acta Neurochirurgica / Issue 10/2009
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-009-0249-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Purpose

Methods & Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods & Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 10/2009

“Phosphene”: early sign of vascular compression neuropathy of the optic nerve

Vertebral artery dissection as an extremely rare cause of spinal epidural hematoma: case report and review of the literature

Restoration of sexual activity in patients with chronic hydrocephalus after shunt placement

Antibiotic-impregnated ventriculo-peritoneal shunts in patients at high risk of infection

Response to Wang et al., re Letter re Visocchi M, Pietrini D, Tufo T, Fernandez E, Di Rocco C (2009) Pre-operative irreducible C1–C2 dislocations: intra-operative reduction and posterior fixation. The “always posterior strategy”. Acta Neurochir (Wien) 151(5):551–9; discussion 560

Quantification of spatial consistency in the Talairach and Tournoux Stereotactic Atlas