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MRI-guided Focused Ultrasound Thalamotomy for Patients with Medically-refractory Essential Tremor
Published on: December 13, 2017
[Surgical techniques and efficacies of deep brain stimulation in the treatment of essential tremor]
Fan-gang MENG1, Yu MA, Ming GE
1Beijing Neurosurgical Institute, Capital Medical University, Beijing 100050, China.
Objective:
To explore the surgical techniques and efficacies of deep brain stimulation (DBS) in the treatment of the patients with essential tremor (ET).
Methods:
A total of 6 ET patients from January 2004 to June 2011 at Department of Neurosurgery, Beijing Tiantan Hospital were recruited to receive DBS at ventral intermediate nucleus of thalamus (Vim-DBS) (n = 5) and subthalamic nucleus (STN-DBS) (n = 1). All underwent stereotactically guided DBS procedures utilizing atlas of neuroanatomy and neurophysiology, pre-operative magnetic resonance imaging (MRI), microelectrode recording and intra-operative testing for target-locating. Postoperative computed tomography (CT) and/or MRI scan were performed after implantation. Such stimulation parameters as stimulus voltage, frequency, pulse width and polarity configuration were adjusted postoperatively to optimize tremor control and maximize battery life. The patients were followed by further consultations or telephone for a comprehensive evaluation of their therapeutic efficacies.
Results:
All patients showed typical electrical signal and relief of tremor symptoms with significant tremor control. No severe adverse events, such as infection, hemorrhage, paresthesia, dysarthria, cognitive deficits, imbalance and diplopia, appeared after the implantation of DBS electrodes.
Conclusion:
Vim-DBS and STN-DBS are both safe and effective for the controls of unilateral and bilateral tremors.
