Ipsilateral Thalamic Stimulation after Thalamotomy for Essential Tremor

Racette, Brad A.; Rich, Keith M.; Randle, Jennifer; Mink, Jonathan W.

doi:10.1159/000048400

Cited by 3 publications

(3 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Longer follow-up has not been possible because she lives 5 h from our institution and she has chosen a more local center to manage her DBS. Nevertheless, this result mirrors previously published accounts of successful thalamic stimulation following thalamotomy in the literature on both RF and gamma-knife thalamotomy [27-29]. …”

Section: Discussionsupporting

confidence: 89%

Thalamic Deep Brain Stimulation Salvages Failed Focused Ultrasound Thalamotomy for Essential Tremor: A Case Report

Wang

Dallapiazza

Moosa

et al. 2018

Stereotact Funct Neurosurg

View full text Add to dashboard Cite

Background: A recent randomized controlled trial investigating unilateral MRI-guided focused ultrasound (FUS) for essential tremor demonstrated efficacy. The long-term durability of this thalamotomy, however, is unknown. Furthermore, the feasibility of stimulating a previously lesioned target such as the thalamic nucleus ventralis intermedius (Vim) is poorly understood. We report a case of tremor recurrence, following an initially successful FUS thalamotomy, in which Vim-DBS was subsequently utilized to regain tremor control. Methods: An 81-year-old right-handed female with medically refractory essential tremor (a Clinical Rating Scale for Tremor [CRST] value of 73) underwent left-sided FUS thalamotomy with initial abolition of right-upper extremity tremor. By the 6-month follow-up, there was complete recurrence of tremor (a CRST value of 76). The patient subsequently underwent left-sided Vim-DBS. Results: Vim-DBS provided clinical improvement with a CRST value of 42 at the 3-month follow-up; the patient continues to do clinically well at the 6-month follow-up. This result mirrors previous reported cases of stimulation following radiofrequency and gamma-knife lesioning. Our literature review highlights several reasons for the waning of clinical benefit seen with lesional procedures. Conclusion: This case demonstrates that thalamic DBS can salvage a failed FUS thalamotomy and also the feasibility of stimulating a previously lesioned target.

show abstract

Section: Discussionsupporting

confidence: 89%

Thalamic Deep Brain Stimulation Salvages Failed Focused Ultrasound Thalamotomy for Essential Tremor: A Case Report

Wang

Dallapiazza

Moosa

et al. 2018

Stereotact Funct Neurosurg

View full text Add to dashboard Cite

show abstract

“…There are few reports in which a combined stimulation and lesioning approach has been applied [21,23,24,30,31,32]. Some reported lesioning followed by stimulation [23,24,30,31], while another performed lesioning after stimulation failed [21].…”

Section: Discussionmentioning

confidence: 99%

“…Some reported lesioning followed by stimulation [23,24,30,31], while another performed lesioning after stimulation failed [21]. The overall conclusion is that this combined approach is safe and effective to the extent that Marello et al [30 ]recommended further investigation to determine if this combined approach could be an alternative to bilateral DBS.…”

Section: Discussionmentioning

confidence: 99%

Lesioning and Stimulation in Tremor-Predominant Movement Disorder Patients: An Institutional Case Series and Patient-Reported Outcome

Bahgat

Raslan

McCartney

et al. 2012

Stereotact Funct Neurosurg

View full text Add to dashboard Cite

Background: In certain movement disorder cases, a combined stimulation and lesioning approach in the same patient could be the ideal beneficial option. Objectives: The object of this study was to retrospectively examine the indications, outcome and complications in patients who had undergone both a lesioning (thalamotomy) and deep brain stimulation (DBS) procedure (bilateral or unilateral) for a tremor-predominant movement disorder performed by a single surgeon at one institution over a 15-year period. Methods: A retrospective review of patient records was undertaken. Patient outcome was based on follow-up visit chart notes and on a non-validated patient telephone questionnaire. Results: Thirty patients required a combined stimulation and lesioning approach to control tremor. Twelve patients had either unilateral or bilateral DBS as the first procedure followed by thalamotomy; two patients required a third procedure. Eighteen patients had thalamotomy as the first procedure followed by contralateral DBS either as the second or the third procedure. Eight patients required three procedures, which included either a repeat thalamotomy or a repeat DBS. We were able to contact 22 of 30 (15 male and 15 female, average age 70.7 ± 15.4 years) tremor-predominant movement disorder patients, retrospectively. Patient-reported outcome as assessed by a non-validated telephone questionnaire was: improvement in both symptoms and function in 59%, symptom but not function improvement in 32% and no improvement in either symptom or function or worsening in 9%. In comparison, based on retrospective chart review, 77% of patients had improved symptoms and functions, 20% of patients had improved symptoms with no effect on function and 3% of patients had no improvements of symptoms or functions. Conclusions: Lesioning, which has to a great extent fallen out of favor, still has a valuable role to play in the treatment of tremor-predominant movement disorders; it can still be applied in combination with stimulation with outcome results similar to that of bilateral stimulation.

show abstract

Surgical Treatment of Tremo

Baba¹,

Uitti²

2005

Neurological Disease and Therapy

View full text Add to dashboard Cite

Ipsilateral Thalamic Stimulation after Thalamotomy for Essential Tremor

Cited by 3 publications

References 14 publications

Thalamic Deep Brain Stimulation Salvages Failed Focused Ultrasound Thalamotomy for Essential Tremor: A Case Report

Thalamic Deep Brain Stimulation Salvages Failed Focused Ultrasound Thalamotomy for Essential Tremor: A Case Report

Lesioning and Stimulation in Tremor-Predominant Movement Disorder Patients: An Institutional Case Series and Patient-Reported Outcome

Surgical Treatment of Tremo

Contact Info

Product

Resources

About