Figure 1
EMG of the lower limb muscles before (a), and nine months after treatment introduction with methimazole (b). The traces show PsOT at 6 Hz, exclusively when the patient was asked to keep the standing position (tremor was absent at rest or at Mingazzini II position). Tremor was characterized by alternated activation among the examined pairs of antagonist muscles (TA, tibialis anterior/GM, gastrocnemius medialis; VL, vastus lateralis/BF, biceps femoris). Only recordings from the right leg are shown, since findings from the left leg were similar.
Figure 2
Qualitative and semiquantitative analysis of [123I]-ioflupane SPECT executed nine months after treatment introduction with methimazole. Values show a mild to moderate hypocaptation in the caudate nucleus, more prominent on the left side, and in the putamen, bilaterally. Captation ratios for left caudatum/occipit 2.70 [3.64+/–0.50] and right caudatum/occipit 2.81 [3.64+/–0.50]; Captation ratios for left putamen/occipit 2.42 [3.02+/–0.56] and right putamen/occipit 2.40 [3.02+/–0.56]. Total striatum/occipit ratio 2.58 [3.23+/–0.50]; putamen/caudatus ratio 0.87 [0.83+/–0.07].
Table 1
Reported cases of OT or PsOT associated with GD. All other instrumental examinations performed other than EMG and thyroid function tests were unremarkable.
| AUTHORS | PATIENT AGE AND SEX | NOTABLE CLINICAL FEATURES | TREMOR FREQUENCY | OTHER INSTRUMENTAL EXAMINATION PERFORMED | TREATMENT |
|---|---|---|---|---|---|
| Lin et all. [12] | 26 years old male | None | 8–9 Hz PsOT | Brain, thoracic and lumbosacral spine MRI | Methimazole |
| Mazzucchi et all. [13] | 70 years old female | Tetrahyperreflexia inability to perform tandem gait | 8 Hz PsOT | Brain, cervical and dorsal spine MRI Motor-evoked potential | Methimazole |
| Tan et all. [14] | 50 years old female | Tremor present only in the right leg | 14–16 Hz OT | Brain and lumbosacral spine MRI | Carbimazole |