This article reports a case of adult scoliosis with limb tremor treated with electroacupuncture. The patient presented with neck stiffness accompanied with limb tremor as the primary symptoms. The pattern was attributed to yang qi deficiency, and the treatment principle focused on unblocking the governor vessel, warming yang, and regulating qi. Acupuncture was applied to Dazhui (GV14), below the spinous processes of C₄-C₆ and bilateral C₄-C₆ Jiaji (EX-B2) points, Feishu (BL13), Xinshu (BL15), Pishu (BL20), Ganshu (BL18), Shenshu (BL23), Dachangshu (BL25). After achieving deqi sensation, bilateral C₄ Jiaji (EX-B2) and C₆ Jiaji (EX-B2) points were separately connected to an SDZ-Ⅴ electroacupuncture device, with continuous wave, 2 Hz of frequency, intensity should be within the tolerance of the patient, the needles were retained for 20 min. For the first 5 months, the treatment was 1-2 times a week, then reduced to 1-2 times a month thereafter. After 30 times of treatment, the patient's bilateral lower limb tremor resolved, the clinical rating scale for tremor (CRST) score was 13 points, the scoliosis showed improvement with about 10° reduction in Cobb angle. At 1-month follow-up, the condition remained stable without progression of scoliosis.
Adult ; Humans ; Acupuncture Points ; Electroacupuncture ; Scoliosis/physiopathology* ; Tremor/complications*

Fragile X-associated tremor/ataxia syndrome(FXTAS) is a neurodegenerative disease caused by FMR1 gene permutation(PM). The main clinical manifestations are intention tremor and/or ataxia, and the pathogenesis was related to RNA toxicity. In this paper, the research progress of clinical manifestatios, pathological characteristics, epidemiology and molecular mechanisms will be reviewed.
Ataxia ; genetics ; Female ; Fragile X Mental Retardation Protein ; genetics ; Fragile X Syndrome ; complications ; diagnosis ; genetics ; pathology ; Humans ; Male ; Tremor ; genetics

Total mesorectal excision (TME) has gained worldwide acceptance as a standard surgical technique in the treatment of rectal cancer. Ever since laparoscopic surgery was first applied to TME for rectal cancer, with increasing penetration rates, especially in Asia, an unstable camera platform, the limited mobility of straight laparoscopic instruments, the two-dimensional imaging, and a poor ergonomic position for surgeons have been regarded as limitations. Robotic technology was developed in an attempt to reduce the limitations of laparoscopic surgery. The robotic system has many advantages, including a more ergonomic position, stable camera platform and stereoscopic view, as well as elimination of tremor and subsequent improved dexterity. Current comparison data between robotic and laparoscopic rectal cancer surgery show similar intraoperative results and morbidity, postoperative recovery, and short-term oncologic outcomes. Potential benefits of a robotic system include reduction of surgeon's fatigue during surgery, improved performance and safety for intracorporeal suture, reduction of postoperative complications, sharper and more meticulous dissection, and completion of autonomic nerve preservation techniques. However, the higher cost for a robotic system still remains an obstacle to wide application, and many socioeconomic issues remain to be solved in the future. In addition, we need more concrete evidence regarding the merits for both patients and surgeons, as well as the merits compared to conventional laparoscopic techniques. Therefore, we need large-scale prospective randomized clinical trials to prove the potential benefits of robot TME for the treatment of rectal cancer.
Asia ; Autonomic Pathways ; Fatigue ; Humans ; Laparoscopy ; Postoperative Complications ; Rectal Neoplasms ; Robotics ; Sutures ; Tremor

OBJECTIVETo investigate the characteristics of cerebral artery lesions in patients with limb-shaking transient ischemic attacks (LS-TIA) and its treatment.

METHODSWe retrospectively analyzed the clinical data of 20 patients with LS-TIA who received treatment in Peking Union Medical College Hospital from 2005 to 2008.

RESULTSCritical stenosis or occlusion of contralateral arteries were found in the siphonic part of internal carotid artery (ICA) in 6 patients, terminal ICA or proximal middle cerebral artery (MCA) in 6 patients, and distal MCA in 1 patient. Seven patients had proximal ICA occlusion. The brain MRI showed typical watershed cerebral infarctions in 8 patients. EEG studies failed to show epileptiform activity associated with LS-TIA, but found focal frontotemporal lobe slow activity in 6 patients, which was consistent with hypoperfusion area in CT perfusion. Six patients received surgical revascularization and no one recurred.

CONCLUSIONIntracranial artery including the siphonic part of ICA, terminal ICA and proximal MCA stenosis is the main underlying cause of LS-TIA in Chinese, and surgical revascularization may be effective in abolishing the attacks.

Adult ; Aged ; Aged, 80 and over ; Cerebral Arteries ; pathology ; Female ; Humans ; Ischemic Attack, Transient ; complications ; pathology ; therapy ; Male ; Middle Aged ; Retrospective Studies ; Tremor ; etiology

Adult ; Brain Stem Neoplasms ; complications ; pathology ; surgery ; Female ; Hemangioma, Cavernous ; complications ; pathology ; surgery ; Humans ; Magnetic Resonance Imaging ; Tremor ; etiology

Posttraumatic tremor is often one of the causes of disability in head injury patients. Usually, pharmacotherapy for this type of tremor is not effective. Since early 1970s, surgical ablation of the ventral thalamus has been used to treat various types of tremor. Nowadays, deep brain stimulation (DBS) confirms its efficacy in alleviating different forms of tremor, including posttraumatic tremor. Such therapy has been reported achieving around 80% success rate in the treatment of posttraumatic tremor. These successful results suggest that the application of DBS therapy can be considered as one of the alternative treatments for minimizing the tremor occurring from different pathologies.
Adult ; Craniocerebral Trauma ; complications ; Deep Brain Stimulation ; methods ; Electrodes ; Humans ; Male ; Tremor ; therapy

OBJECTIVE: This study is designed to evaluate the usefulness of the cutaneous external landmarks in the application of a Leksell stereotactic frame for functional stereotactic surgery. METHODS: Surgical procedures included thalamotomy in 12 and pallidotomy in 4. Thalamotomy and later pallidotomy were performed in one. In application of the Leksell stereotactic frame, the authors used the cutaneous external landmarks including: (1) the pupil and the external acoustic meatus in group I, (2) the pupil and the crus of the helix in group II, (3) the lateral canthus, the crus of the helix, and inferior crura of antihelix in group III. This procedure was done for obtaining magnetic resonance(MR) images showing anterior and posterior commissure in the same axial scan. The targets were Vim for thalamotomy and GPi for pallidotomy. RESULTS: All MR images in group I, II, and III showed anterior and posterior commissures in the same axial scans except for two patients (17.7%) in group I. The MRI coordinate was accurate to localize the target within 1mm of the difference from electrophysiologic target in 76% of the patients. After surgery, a significant improvement was noticed in tremor scale and global outcome scale (p<0.05), but not in total unified parkinson disease rating scale score and Hoehn and Yahr stage (p>0.05). Transient postoperative complications including motor aphasia and hemihypesthesia were noticed in one each, which returned normal in 3 months. CONCLUSION: The cutaneous external landmarks are of value in applying Leksell stereotactic frame for obtaining magnetic resonance images, essentially showing anterior and posterior commissure. This method is also useful in saving total operation time, making patients comfortable, as well as cost effectiveness.
Aphasia, Broca ; Cost-Benefit Analysis ; Ear Canal ; Humans ; Magnetic Resonance Imaging ; Pallidotomy ; Parkinson Disease ; Postoperative Complications ; Pupil ; Tremor