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$MRI-guided Focused Ultrasound Thalamotomy for Patients with Medically-refractory Essential Tremor$

MRI-guided Focused Ultrasound Thalamotomy for Patients with Medically-refractory Essential Tremor

Published on: December 13, 2017

Deep brain stimulation for essential tremor.

Jules M Nazzaro¹, Kelly E Lyons, Rajesh Pahwa

¹Department of Neurosurgery, University of Kansas Medical Center, Kansas City, KS, USA; Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA; Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, KS, USA.

Handbook of Clinical Neurology

|October 12, 2013

Summary

This summary is machine-generated.

Essential tremor, a common movement disorder, often limits daily activities. Deep brain stimulation (DBS) of the ventral intermediate nucleus (VIM) offers benefits for medication-resistant tremor.

Keywords:

VIM DBS VIM stimulation deep brain stimulation essential tremor thalamic DBS thalamic stimulation

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Area of Science:

Neurology
Neurosurgery

Background:

Essential tremor is the most prevalent tremor disorder, characterized by postural and kinetic tremors, frequently impacting adults and limiting daily function.
Medication is often insufficient for managing severe essential tremor, historically leading to surgical interventions like VIM thalamotomy.

Observation:

Deep brain stimulation (DBS) targeting the ventral intermediate nucleus (VIM) of the thalamus has largely superseded thalamotomy for essential tremor due to reduced neurological deficit risks.
Studies confirm unilateral VIM DBS provides significant short- and long-term tremor control, potentially improving head and voice tremor, though bilateral stimulation is often needed.

Findings:

Bilateral VIM DBS, while effective for tremor, is associated with an increased risk of neurological deficits, particularly affecting speech and gait.
Ongoing research explores alternative DBS targets, including the posterior subthalamic area and subthalamic nucleus, for essential tremor management.

Implications:

VIM DBS represents a significant advancement in treating medication-resistant essential tremor, offering improved quality of life for affected individuals.
Further research into DBS targets and stimulation parameters is crucial for optimizing efficacy and minimizing side effects in essential tremor treatment.