Multiple sclerosis and related disorders · 2025
Progressive unilateral tremor associated with large confluent perirolandic juxtacortical lesions in multiple sclerosis.
Письмо в редакциюНазвание и аннотация: Перевод в очереди
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Banks Samantha A, Klassen Bryan T, Bower James H, Budhram Adrian, Kantarci Orhun H, Benarroch Eduardo E, Nathoo Nabeela, Tobin W Oliver, Pittock Sean J, Keegan B Mark, Toledano Michel, Zekeridou Anastasia, Ali Farwa, Flanagan Eoin P
Аннотация
BACKGROUND: Multiple sclerosis (MS)-related tremor is classically attributed to infratentorial lesions.
OBJECTIVE: To characterize unilateral tremor associated with perirolandic lesions in MS.
METHODS: This retrospective study included Mayo Clinic patients diagnosed with MS who had: 1) Progressive unilateral tremor; and 2) Contralateral perirolandic juxtacortical T2-lesion. Medical records, neuroimaging and movement laboratory studies were evaluated.
RESULTS: Of 12 patients, 8 were female. Median age of tremor onset was 36.5 years (range, 23-49), with diagnosis of MS a median of 101 months (range, 5-238) after. Tremor was the first MS symptom in 10 and all had progression. Most had tremors (10/12) in the 4.5 - 7 Hz range, while 2 had Holmes tremors in 3 - 5 Hz range. The perirolandic lesions were often large and confluent. All 3 with acute/subacute MRIs (within 4 months of onset) had enhancement. There was lesional atrophy in 6/11 with follow-up imaging available. Detailed treatment outcomes are described.
CONCLUSION: Progressive unilateral tremor with contralateral perirolandic lesion is a novel phenotype of progressive MS and the pathogenesis may reflect disruption of cerebello-thalamo-cortical circuitry.
OBJECTIVE: To characterize unilateral tremor associated with perirolandic lesions in MS.
METHODS: This retrospective study included Mayo Clinic patients diagnosed with MS who had: 1) Progressive unilateral tremor; and 2) Contralateral perirolandic juxtacortical T2-lesion. Medical records, neuroimaging and movement laboratory studies were evaluated.
RESULTS: Of 12 patients, 8 were female. Median age of tremor onset was 36.5 years (range, 23-49), with diagnosis of MS a median of 101 months (range, 5-238) after. Tremor was the first MS symptom in 10 and all had progression. Most had tremors (10/12) in the 4.5 - 7 Hz range, while 2 had Holmes tremors in 3 - 5 Hz range. The perirolandic lesions were often large and confluent. All 3 with acute/subacute MRIs (within 4 months of onset) had enhancement. There was lesional atrophy in 6/11 with follow-up imaging available. Detailed treatment outcomes are described.
CONCLUSION: Progressive unilateral tremor with contralateral perirolandic lesion is a novel phenotype of progressive MS and the pathogenesis may reflect disruption of cerebello-thalamo-cortical circuitry.