Relato de caso tremor de holmes e breve revisão da literatura

Autores

  • Carolina Simão Martini
  • Raphael Gonzaga
  • Alexandre Pingarilho
  • Paulo Roberto Franceschini
  • Roberto Alexandre Dezena
  • Paulo Henrique Pires de Aguiar

DOI:

https://doi.org/10.22290/jbnc.v32i4.1988

Palavras-chave:

Tremor de Holmes, Estimulação cerebral profunda, Neurocirurgia funcional

Resumo

Introdução: O tremor de Holmes é um tremor de baixa frequência com apresentação irregular no repouso e intenção, sem um componente postural obrigatório. A fisiopatologia, embora não completamente elucidada, pode ser explicada por uma lesão nos circuitos córtico-tálamo-cerebelo cortical e córtico-estriado-talâmico. Pode ser tratado de maneira conservadora – farmacológica– ou através de neurocirurgia. É relatado um caso em que a cirurgia foi o tratamento de escolha, resultando numa estimulação do Núcleo Ventral Intermédio (Vim) e da Zona Incerta (ZI). Relato do Caso: Paciente do sexo feminino, 41 anos, com tremor de Holmes envolvendo ambos os membros superiores, sendo mais predominante do lado direito, afetando mais a região proximal do que distal, de ação e de repouso, exacerbado com ansiedade e estresse. Devido ao comprometimento funcional e da falha no tratamento conservador com farmacoterapia, foi realizada a implantação de dois eletrodos, um com alvo no Vim outro na ZI, ambos do lado esquerdo. Conclusão: O tremor de Holmes é uma síndrome complexa com fisiopatologia não totalmente entendida. O relato de caso descreve o implante cirúrgico de eletrodos que tiveram resultados positivos para a paciente.

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Biografia do Autor

Carolina Simão Martini

Student of Medicine, School of Medicine, Pontifical Catholic University of Sorocaba, São Paulo, Brazil

Raphael Gonzaga

MD, Department of Neurosurgery, Santa Paula Hospital, São Paulo

Alexandre Pingarilho

MD, Department of Neurosurgery, Santa Paula Hospital, São Paulo

Paulo Roberto Franceschini

MD, PhD, Department of Neurosurgery, Hospital Saúde de Caxias do Sul, Caxias do Sul

Roberto Alexandre Dezena

MD, PhD, Division of Neurosurgery, Federal University of Uberaba (UFTM), Uberaba, Minas Gerais, Brazil

Paulo Henrique Pires de Aguiar

MD, Department of Neurosurgery, Santa Paula Hospital, São Paulo. MD, PhD, Department of Neurology, Pontifical Catholic University of São Paulo, Sorocaba, Brazil.

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Publicado

2022-01-06

Como Citar

1.
Martini CS, Gonzaga R, Pingarilho A, Franceschini PR, Dezena RA, Aguiar PHP de. Relato de caso tremor de holmes e breve revisão da literatura. jbnc [Internet]. 6º de janeiro de 2022 [citado 26º de maio de 2022];32(4):367-78. Disponível em: https://jbnc.emnuvens.com.br/jbnc/article/view/1988

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