Deep brain stimulation and other surgical modalities for the management of essential tremor.
Expert Rev Med Devices
; 17(8): 817-833, 2020 Aug.
Article
in En
| MEDLINE
| ID: mdl-33081571
ABSTRACT
INTRODUCTION:
Surgical treatments are considered for essential tremor (ET) when patients do not respond to oral pharmacological therapies. These treatments mainly comprise radiofrequency (RF) thalamotomy, gamma knife radiosurgery (GKRS), deep brain stimulation (DBS), and focused ultrasound (FUS) procedures. AREAS COVERED We reviewed the strengths and weaknesses of each procedure and clinical outcomes for 7 RF studies (n = 85), 11 GKRS (n = 477), 33 DBS (n = 1061), and 13 FUS studies (n = 368). A formal comparison was not possible given the heterogeneity in studies. Improvements were about 42%-90% RF, 10%-79% GKRS, 45%-83% DBS, 42%-83% FUS at short-term follow-up (<12 months) and were about 54%-82% RF, 11%-84% GKRS, 18%-92% DBS, and 42%-80% FUS at long-term follow-up (>12 months). EXPERT OPINION We found DBS with inherent advantages of being an adjustable and reversible procedure as the most frequently employed surgical procedure for control of ET symptoms. FUS is a promising procedure but has limited applicability for unilateral control of symptoms. RF is invasive, and GKRS has unpredictable delayed effects. Each of these surgical modalities has advantages and limitations that need consideration when selecting a treatment for the ET patients.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Essential Tremor
/
Deep Brain Stimulation
Type of study:
Diagnostic_studies
Limits:
Humans
Language:
En
Journal:
Expert Rev Med Devices
Journal subject:
DIAGNOSTICO POR IMAGEM
/
TERAPEUTICA
Year:
2020
Document type:
Article
Affiliation country:
China
Publication country:
ENGLAND
/
ESCOCIA
/
GB
/
GREAT BRITAIN
/
INGLATERRA
/
REINO UNIDO
/
SCOTLAND
/
UK
/
UNITED KINGDOM