Bilateral Radiofrequency Ventral Intermediate Thalamotomy for Essential Tremor

Area of Science:

• Neurosurgery
• Neurology
• Medical Devices

Background:

• Essential tremor (ET) treatment efficacy and safety are increasingly important with MR-guided focused ultrasound advancements.
• Published reports on bilateral Vim thalamotomy for ET are limited.

Purpose of the Study:

• To review the efficacy and safety outcomes of bilateral Vim thalamotomy for essential tremor affecting upper extremities.
• To analyze complications and adverse events associated with staged bilateral Vim thalamotomy.

Main Methods:

• Retrospective analysis of patients with ET undergoing staged bilateral Vim thalamotomy using radiofrequency (RF) thermal coagulation.
• Efficacy assessed using the Clinical Rating Scale for Tremor (CRST) pre- and post-treatment.
• Complications and adverse events were systematically evaluated.

Main Results:

• Significant tremor reduction observed after both first (40.4% improvement) and second (78.6% improvement) thalamotomies.
• CRST scores improved from 34.9 pre-treatment to 7.4 post-second thalamotomy.
• Nine patients experienced mild, non-interfering prolonged adverse events (e.g., dysarthria, dysphagia).

Conclusions:

• Bilateral Vim thalamotomy with RF thermal coagulation is an effective treatment for essential tremor in the upper extremities.
• While complications were generally mild, larger studies are necessary to fully ascertain patient safety.