essential_tremor_treatment

Essential tremor treatment

Thalamic stimulation may be useful for tremors that are refractory to medical treatment, including tremor dominant Parkinson's disease, essential tremor, 1), 2) cerebellar and posttraumatic tremor 3). Prior to being considered for surgical intervention, it should be determined that the patient has failed maximal medical therapy. Side effects of Vim stimulation include paresthesias, H/A, dysequilibrium, dysarthria, dystonia & localized pain.

Drug-resistant essential tremor (ET) can benefit from open standard stereotactic procedures, such as deep-brain stimulation or radiofrequency thalamotomy. Non-surgical candidates can be offered either high-focused ultrasound (HIFU) or radiosurgery (RS).

All procedures aim to target the same thalamic site, the ventro-intermediate nucleus (e.g., VIM). The mechanisms by which tremor stops after Vim RS or HIFU remain unknown.

Magnetic resonance guided focused ultrasound thalamotomy for essential tremor.

Deep brain stimulation for essential tremor.


1)
Sydow O, Thobois S, Alesch F, et al. Multicentre European study of thalamic stimulation in essential tremor: a six-year follow-up. J Neurol Neurosurg Psychiatry. 2003; 74:1387–1391
2)
Schuurman PR, Bosch DA, Merkus MP, et al. Long-term follow-up of thalamic stimulation versus thalamotomy for tremor suppression. Mov Disord. 2008; 23:1146–1153
3)
Jankovic J, Cardoso F, Grossman RG, et al. Outcome After Stereotactic Thalamotomy for Parkinsonian, Essential, and Other Types of Tremor. Neurosurgery. 1995; 37:680–687
  • essential_tremor_treatment.txt
  • Last modified: 2022/08/05 16:48
  • by administrador