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Master Thesis

Tremblement mésencéphalique : apport d’une stratégie d’injection de toxine botulique guidée par enregistrement polygraphique

Abstract : Background: we aimed to analyse proximal upper limbs tremor from a polygraph record and to show that a strategy of injection guided by polygraph registration was effective. The evaluation of the effect was based on Fahn Tolosa Marin modified (FTMm) and on the Canadian Occupational Performance Measure (COPM). Patients and methods: we analyzed muscles involved in the tremor from the polygraph record to guide the strategy of botulinum toxin injection. Patients were reviewed in a month to assess the effectiveness and tolerance of treatment. Results: eleven patients were included in the study (8 female and 3 men). The majority ( 82%) had multiple sclerosis. The tremor was present for an average of 8 years. Our study shows the involvement of the deltoid muscle in the tremor of the upper limb and our work shows a significant decrease of tremor after one month on FTMm (50.6 ± 4.32; 43.2 ± 4.59; p = 0.042) and on upper extremity-specific clinical rating (16 ± 6.0; 11 ± 5.7; p = 0.043) without significant modification of the COPM. One patient developed slight weakness of shoulder abduction. Conclusion: the current findings support the efficacity of injection of botulinum toxin guided by polygraph record in the treatment of mesencephalic tremor or Holmes tremor.
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Master Thesis
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Fanny Lecaron Jomier. Tremblement mésencéphalique : apport d’une stratégie d’injection de toxine botulique guidée par enregistrement polygraphique. Médecine humaine et pathologie. 2017. ⟨dumas-01741862⟩

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