{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:30:05Z","timestamp":1761006605737,"version":"build-2065373602"},"reference-count":52,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,5,24]],"date-time":"2022-05-24T00:00:00Z","timestamp":1653350400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To present a case of refractory medication\u2010induced tremor successfully treated with deep brain stimulation (DBS) of the thalamic ventral intermediate nucleus (Vim) and to propose a medical and surgical treatment algorithm based on a systematical review of the literature.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patient data were retrospectively collected. A systematic search was performed in PubMed, Embase, and Cochrane Library. Subjective and objective data were pooled for analysis by classifying them into 5 predefined categories(no, minimal, moderate, good, and excellent effects).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The patient presented with lithium\u2010induced bilateral progressive hand tremor lasting 25\u2009years. After DBS, he reported excellent tremor suppression until the last follow\u2010up (36\u2009months after Vim\u2010DBS). For the review, 34 of 140 studies were included and evaluated (178 unique subjects, 31 different treatments). A good\u2010to\u2010excellent tremor suppression (50%\u2013100%) in at least 50% of subjects was achieved using propranolol (12 studies, 50% of 56 subjects), tetrabenazine (5 studies, 51% of 13 subjects), and metoprolol (4 studies, 75% of 8 subjects). The effect of benztropine and diphenhydramine was none or only minimal to moderate (up to 50% improvement; both: 3 studies, 50% of 4 patients). One article reported minimal\u2010to\u2010moderate effectiveness after DBS of the ventral oral posterior nucleus of the thalamus. Methods were highly heterogeneous. All studies scored grade III or IV quality of evidence, which was insufficient for recommendations (level U).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Treatment decision making should be performed on a case\u2010by\u2010case basis considering the low level of evidence, and we propose a practically oriented treatment algorithm. Propranolol, tetrabenazine, and metoprolol might be effective. For selected and refractory cases, DBS might be considered.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mdc3.13463","type":"journal-article","created":{"date-parts":[[2022,4,21]],"date-time":"2022-04-21T00:50:48Z","timestamp":1650502248000},"page":"676-687","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Medical and Surgical Treatment for Medication\u2010Induced Tremor: Case Report and Systematic Review"],"prefix":"10.1002","volume":"9","author":[{"given":"Wardell E.","family":"Amerika","sequence":"first","affiliation":[{"name":"Department of Neurology Haga Teaching Hospital  The Hague The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saskia","family":"van der Gaag","sequence":"additional","affiliation":[{"name":"Department of Neurology Haga Teaching Hospital  The Hague The 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