PMC3569976_01
Pre-operative surface EMG of the right anterior tibialis in the movement neurophysiology laboratory shows well-formed, continuous, and rhythmic 13 Hz tremor bursts, which are noted immediately upon standing in place from a seated position. The tracing shows a 2-second epoch.
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This was assisted by surface EMG recordings of the legs, asking the patient to push down on each leg against resistance or on a footboard (Figure 1).
3-month postoperative surface EMG of the right anterior tibialis in the movement neurophysiology laboratory demonstrates less continuous, less rhythmic, and slower frequency (5-10 Hz) tremor bursts. The tracing shows a 2-second epoch.
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Final electrode placement per side was determined based on stimulation side effects (sensory symptoms in the contralateral leg) and improvement of the contralateral leg tremor on surface EMG with macrostimulation (Figure 2).
Intraoperative surface EMG recordings of the right anterior tibialis prior to stimulation with the patient supine in the operating table shows irregular 12-15 Hz tremor bursts while having the patient push down on the leg against resistance. The tracing shows a 1-second epoch. RATIB, Right anterior tibialis (muscle).
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On standing from a seated position, there was immediate onset of tremor in the lower extremities on surface EMG, although the tremor bursts were less continuous, less rhythmic, and often showing bursts of slower frequency than the previous 13 Hz tremor seen pre-operatively (Figures 3-4).
Intraoperative surface EMG recordings of the right anterior tibialis during macrostimulation with the patient supine in the operating table shows no definite tremor bursts while pushing down on the leg against resistance. The tracing shows a 1-second epoch. RATIB, Right anterior tibialis (muscle).
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On standing from a seated position, there was immediate onset of tremor in the lower extremities on surface EMG, although the tremor bursts were less continuous, less rhythmic, and often showing bursts of slower frequency than the previous 13 Hz tremor seen pre-operatively (Figures 3-4).