Figure 1
MRI brain. Preoperative MRI revealing late sequela of demyelination with brain atrophy and pathy areas of secondary axonal loss throughout the brain and concavity of the apex of the midbrain.
Table 1
Fahn, Tolosa, Marin Tremor Rating scale with the deep brain stimulation turned on and off.
| OFF STIM | ON STIM | ON ADJUSTED STIM | |||||||
|---|---|---|---|---|---|---|---|---|---|
| REST | POST | ACTION | REST | POST | ACTION | REST | POST | ACTION | |
| 1. Face1 | 0 | – | – | 0 | – | – | 0 | – | – |
| 2. Tongue | 0 | 0 | – | 0 | 0 | – | 0 | 0 | – |
| 3. Voice | – | – | 1 | – | – | 1 | – | – | 1 |
| 4. Head | 0 | 0 | – | 0 | 0 | – | 0 | 0 | – |
| 5. RUE | 2 | 3 | 3 | 1 | 2 | 2 | 1 | 2 | 2 |
| 6. LUE | 3 | 4 | 4 | 1 | 3 | 3 | 1 | 3 | 3 |
| 7. Trunk | 0 | 0 | – | 0 | 0 | – | 0 | 0 | – |
| 8. RLE | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| 9. LLE | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Total | 5 | 7 | 8 | –– | – | – | 2 | 5 | 6 |
| RIGHT | LEFT | N/A | RIGHT | LEFT | N/A | RIGHT | LEFT | N/A | |
| 10. Handwriting2 | – | – | 4 | – | – | – | – | – | 3 |
| 11. Drawing A3 | 4 | 4 | – | – | – | – | 2 | 3 | – |
| 12. Drawing B | 4 | 4 | – | – | – | – | 2 | 3 | – |
| 13. Drawing C | 4 | 4 | – | – | – | – | 2 | 3 | – |
| 14. Pouring4 | 4 | 4 | – | 3 | 4 | – | 3 | 4 | – |
| 15. Speaking5 | – | – | 2 | – | – | – | – | – | 2 |
| 16. Feeding other than liquids6 | – | – | 4 | – | – | – | – | – | 2 |
| 17. Bringing liquids to mouth | – | – | 4 | – | – | – | – | – | 3 |
| 18. Hygiene | – | – | 4 | – | – | – | – | – | 4 |
| 19. Dressing | – | – | 4 | – | – | – | – | – | 3 |
| 20. Writing | – | – | 4 | – | – | – | – | – | 3 |
| 21. Working7 | – | – | 4 | – | – | – | – | – | 3 |
| Total | 16 | 16 | 30 | – | – | – | 9 | 13 | 23 |
| Overall Total Score | 82 | 58 | |||||||
[i] 1Definitions for 1–9: 0 = none; 1 = slight; 2 = moderate amplitude; 3 – marked amplitude; 4 = severe amplitude; 2Definitons for 10: 0 = normal; 1 = mildly abnormal; 2 = moderately abnormal; 3 = marked abnormal; 4 = severely abnormal; 3Definitions for 11–13: 0 = normal; 1 = slightly tremulous; 2 = moderately tremulous; 3 = accomplishes the task with great difficulty; 4 = unable to complete; 4Pouring: 0 = normal; 1 = more careful than a person without tremor; 2 = spills a small amount; 3 = spills a considerable amount; 4 = unable to pour water; 5Speaking: 0 = normal; 1 = mild voice tremulousness when “nervous” only; 2 = mild voice tremor, constant; 3 = moderate; 4 = severe, some words are difficult to understand; 6Definition 16–20: 0 = normal 1 = mildly normal; 2 = moderately abnormal; 3 = markedly abnormal; 4 = severely abnormal; 7Working: 0 = tremor does not interfere with job; 1 = able to work, but needs to be more careful than the average person; 2 = able to do everything, but with errors; 3 = unable to do regular job. May have changed to a different job because of tremor; 4 = Unable to do any outside job.
Figure 2
Fahn-Tolosa-Marin rating scale of tremor Drawings A, B and C. Drawings with stimulation on, using left hand (left) and right hand (right). Drawings with the stimulation off are not shown because the patient was not able to perform either task.