The safety and efficacy of thalamic deep brain stimulation in essential tremor: 10 years and beyond.
J Neurol Neurosurg Psychiatry
; 85(5): 567-72, 2014 May.
Article
en En
| MEDLINE
| ID: mdl-24096713
ABSTRACT
BACKGROUND:
Deep brain stimulation (DBS) has proven to be a safe and effective therapy for refractory essential tremor, but information regarding long-term outcomes is lacking.OBJECTIVES:
We aimed to assess the long-term safety and efficacy of DBS in patients with essential tremor.METHODS:
Patients treated with DBS for essential tremor for at least 8 years were evaluated in the 'on' and 'off' state using the Fahn-Tolosa-Marin tremor rating scale, and their medical records were reviewed to assess complications related to this therapy.RESULTS:
We studied 13 patients (7 men) median age at evaluation 79 years (range 47-88), median age at electrode implantation 68 years (range 37-78) and mean time since electrode implantation 132.54±15.3 months (range 114-164). The difference between the 'off' and 'on' state on the motor items of the tremor rating scale was 41.9% (58.62 vs. 34.08, p<0.001) in the non-blinded and 37.2% (56.07 vs. 35.23, p<0.001) in the blinded rating. DBS provided a functional improvement of 31.7% in the 'on' state (15.07 vs. 22.07, p<0.001). A total non-blinded improvement in the tremor rating scale of 39% was observed in the 'on' state (49.15 vs. 80.69, p<0.001). Dysarthria and disequilibrium were common in patients with bilateral stimulation. A DBS-related surgery (electrode revision or internal pulse generator exchange) was necessary on average every 47.9 months to continue with the DBS therapy.CONCLUSIONS:
Thalamic DBS is a safe and effective therapy in patients with essential tremor followed for up to 13 years.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Temblor Esencial
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Estimulación Encefálica Profunda
Tipo de estudio:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Neurol Neurosurg Psychiatry
Año:
2014
Tipo del documento:
Article
País de afiliación:
Estados Unidos