Tremor treatment

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Tremor is the most common movement disorder (intention>postural>resting), with essential tremor affecting 5–10 million persons in the U.S. Thalamic stimulation may be useful for tremors that are refractory to medical treatment, including tremor dominant Parkinson's disease, essential tremor, ¹⁾ ²⁾ cerebellar and posttraumatic tremor ³⁾.

Before being considered for surgical intervention, it should be determined that the patient has failed maximal medical therapy.

Side effects of Vim stimulation include: paresthesias, H/A, dysequilibrium, dysarthria, dystonia & localized pain.

Purrer V, Upadhyay N, Borger V, Schmeel C, Boecker H, Wüllner U. Structural and functional alterations in the gustatory network underlie taste disturbances after lesional tremor therapy with MRgFUS. J Neurol Neurosurg Psychiatry. 2023 Jun 15:jnnp-2023-331324. doi: 10.1136/jnnp-2023-331324. Epub ahead of print. PMID: 37321839.

Focused ultrasound

¹⁾

Sydow O, Thobois S, Alesch F, et al. Multicentre European study of thalamic stimulation in essen- tial tremor: a six year follow up. J Neurol Neurosurg Psychiatry. 2003; 74:1387–1391

²⁾

Schuurman PR, Bosch DA, Merkus MP, et al. Long- term follow-up of thalamic stimulation versus tha- lamotomy for tremor suppression. Mov Disord. 2008; 23:1146–1153

³⁾

Jankovic J, Cardoso F, Grossman RG, et al. Outcome After Stereotactic Thalamotomy for Parkinsonian, Essential, and Other Types of Tremor. Neuro- surgery. 1995; 37:680–687