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Pharmacologic treatment for essential tremor and the tremor of Parkinson's disease is often inadequate.Stereotaxic surgery such as thalamotomy,can effective reduce tremors.We performed a multicenter trial of unilateral high-frequency stimulation of the ventral intermedius nucleus of the thalamus in 29 patients with essential tremor and 24 patients with Parkinson's disease,using a blinded assessment at 3 months after surgery to compare clinical rating of tremor with stimulation ON with stimulation OFF and baseline and 1-year follow-up.Six patients were not implanted because of lack of intraoperative tremor suppression(2 patients), hemorrhage(2 patients),withdrawal of consent(1 patient)and persistent microthalamotomy effect(1 patient).A significant reduction in both essential and parkinsonian function were significantly improved in patients with essential tremor.complications related to surgery in implanted patients were few.Stimulation was commonly associated with transient paresthesias.Other adverse effects were mild and well tolerated. Efficacy was not reduced at one year.Chronic high frequency stimulation is safe and highly effective in ameliorating essential and parkinsonian tremor. |
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benign essential tremor
neurologic complications of,surgery
Parkinson disease
Parkinson disease,surgical treatment of
Parkinson disease,treatment of
stimulation,deep brain
treatment of neurologic disorder
tremor
tremor,surgical treatment of
tremor,thalamic stimulation for suppression of
tremor,treatment of
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