| Feature | Thalamotomy | Subthalamotomy |
|---|---|---|
| Target structure | Thalamus (mainly VIM nucleus) | Subthalamic nucleus (STN) |
| Main use | Tremor control | Tremor, bradykinesia, rigidity control |
| Common in | Tremor-dominant Parkinson’s, essential tremor | Parkinson’s disease (all motor symptoms) |
| Typical side effects | Sensory deficits, dysarthria | Hemiballismus (involuntary flinging movements), speech or mood changes |
| Anatomical position | Above the subthalamus | Below the thalamus |
Medial thalamotomy and thalamotomy are related but not the same.
Here’s the key difference:
“Thalamotomy” is a general term. It simply means making a lesion in the thalamus to treat a neurological disorder (like tremor, pain, dystonia, etc.). The thalamus is large and has many different nuclei, so thalamotomy could target different parts depending on the disease and symptoms.
“Medial thalamotomy” is a specific type of thalamotomy. It refers to lesioning more medial nuclei of the thalamus, often targeting areas involved in chronic pain (like the centromedian-parafascicular complex, intralaminar nuclei, etc.). It’s less common for treating Parkinsonian tremor, where usually a ventrolateral thalamotomy (especially VIM — ventral intermediate nucleus) is preferred.
In short:
Every medial thalamotomy is a thalamotomy,
But not every thalamotomy is a medial thalamotomy.
When treating Tremor-predominant Parkinson's disease, VIM thalamotomy (lateral part) is the standard, not medial thalamotomy.