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Primary writing tremor treated by stereotactic selective thalamotomy
Journal of Neurology, Neurosurgery, and Psychiatry
|November 1, 1982
Summary
Primary writing tremor, a neurological disorder, was successfully treated with stereotactic thalamotomy. This surgical intervention targeted the ventralis intermedius nucleus, offering a potential solution for patients with this condition.
Area of Science:
- Neurology
- Neurosurgery
- Neuroscience
Background:
- Primary writing tremor is a debilitating condition characterized by involuntary shaking during handwriting.
- The exact pathophysiology of primary writing tremor remains incompletely understood, necessitating further investigation.
- Stereotactic thalamotomy is a surgical procedure involving precise lesioning within the thalamus.
Observation:
- Three patients with progressive, coarse tremor (5-7 Hz) during writing and Westphal's phenomenon were studied.
- These patients presented with writing tremor as their sole neurological manifestation.
- Electrophysiological recordings within the thalamus revealed a high incidence of irregular burst discharges.
Findings:
- Stereotactic selective thalamotomy, focused on the ventralis intermedius nucleus, resulted in successful tremor reduction.
- The presence of irregular burst discharges in the thalamus correlates with the observed tremor.
- These clinical and electrophysiological findings support the classification of writing tremor as an organic neurological disorder.
Implications:
- Stereotactic thalamotomy offers a viable and effective treatment option for severe primary writing tremor.
- Understanding the thalamic circuitry involved in writing tremor can lead to more targeted therapeutic strategies.
- This study contributes to the growing body of evidence classifying writing tremor as a distinct organic neurological condition.