Bilateral Ventral Intermediate Nucleus Thalamic Deep Brain Stimulation in Orthostatic Tremor.
Stereotact Funct Neurosurg
; 94(2): 69-74, 2016.
Article
in En
| MEDLINE
| ID: mdl-27002536
ABSTRACT
BACKGROUND:
Orthostatic tremor (OT) is characterized by high-frequency leg tremor when standing still, resulting in a sense of imbalance, with limited treatment options. Ventral intermediate (Vim) nucleus thalamic deep brain stimulation (DBS) has been reported as beneficial in a few cases.OBJECTIVE:
To report clinical outcomes, lead locations, and stimulation parameters in 2 patients with severe medication-refractory OT treated with Vim DBS.METHODS:
The patients underwent surface electromyography (EMG) to confirm the OT diagnosis. Outcomes were measured as change in tolerated standing time at the last follow-up. Lead locations were quantified using postoperative MRI.RESULTS:
Vim DBS was well tolerated and resulted in improvement in standing time (patient 1 50 s at baseline to 15 min 16 months after surgery; patient 2 34 s at baseline to 4.2 min 7 months after surgery). Postoperative surface EMG for patient 1 demonstrated a delayed onset of tremor, lower-amplitude tremor, and periods of quiescence, but an unchanged tremor frequency.CONCLUSION:
These cases provide further support for Vim DBS to improve standing time in severe medication-refractory OT. The location of the effective thalamic target for OT does not differ from the effective target for essential tremor.
Full text:
1
Database:
MEDLINE
Main subject:
Tremor
/
Ventral Thalamic Nuclei
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Deep Brain Stimulation
/
Dizziness
Limits:
Aged
/
Female
/
Humans
/
Middle aged
Language:
En
Year:
2016
Type:
Article