Long-Term Results of Stereotaxy in the Treatment of Essential Tremor

Mohadjer, M.; Goerke, H; Milios, Elias; Etou, A.; Mundinger, F.

doi:10.1159/000100201

Cited by 81 publications

(56 citation statements)

References 9 publications

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“…Five series have evaluated the effectiveness of VIM thalamotomy for treatment of ET since 1980 [5][6][7][8][9]. In the largest series, Mohadjer et al [5] reported 93.7% immediate improvement after stereotactic thalamotomy in 105 ET patients.…”

Section: Discussionmentioning

confidence: 99%

“…Although ET occurs more frequently than Parkinson's disease, the number of patients referred for surgery is relatively small. Only a few studies have focused on surgical treatment of ET, and long-term results of stereotactic VIM thalamotomy in patients with ET are not well represented in the literature [5][6][7][8][9]. We have summarized our experience with stereotactic VIM thalamotomy for treatment of medically intractable ET and present here our results from a series of 43 thalamotomies performed in 37 patients.…”

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confidence: 99%

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Stereotactic Ventral Intermedial Thalamotomy for the Treatment of Essential Tremor:Results of a Series of 37 Patients

Kj³

1999

Stereotact Funct Neurosurg

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We have analyzed 43 ventral intermediate thalamotomies performed in our center for treatment of medically intractable essential tremor (ET) in 37 patients. The mean age of patients was 70.9 years (range 42–84), duration of symptoms 33.3 years (1–65). The surgery in all cases was performed with stereotactic technique using MRI or CT localization. Intraoperative neurophysiological confirmation of the target location was obtained using a macrostimulation technique. All patients experienced either complete abolition of the contralateral tremor or significant improvement in tremor intensity immediately after the surgery. At follow-up examination 1–13 months after the operation, 60.5% of patients had no tremor, and 13.9% had mild residual tremor without interference with daily life. Tremor recurrence was observed in 5 patients, all of whom underwent repeat ventral intermedial (VIM) thalamotomy with excellent results. Transient problems with speech and motor functions were observed after 15 thalamotomies, permanent hemiparesis and speech difficulties were seen in 6 patients. We conclude that VIM thalamotomy is a highly effective procedure for medically intractable ET and may be performed with no mortality and low morbidity rate.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Stereotactic Ventral Intermedial Thalamotomy for the Treatment of Essential Tremor:Results of a Series of 37 Patients

Kj³

1999

Stereotact Funct Neurosurg

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“…This might suggest some lasting effect since it may be assumed that the patients at baseline had a more severe tremor in the treated hand. In the literature, beneficial results have also been reported in long-term evaluations [17][18][19][20][21][22][23][24][25][26][27]. In some patients the tremor has not been shown to recur during the follow-up time [22].…”

Section: Discussion Tremormentioning

confidence: 92%

“…The most frequently described side effects included cerebellar complications such as speech difficulties (dysarthria, dysphasia, hypophonia), dysequlibrium, apraxia, ataxia, and gait disturbances, as well as contralateral weakness, most probably due to affection of the internal capsule [3, 19, 21-24, 26, 27, 29-33]. Facial numbness and weakness as well as cognitive impairment have also been described [19,20,27,34].…”

Section: Side Effectsmentioning

confidence: 99%

Thalamotomy for Essential Tremor: A Very Long-Term Follow-Up

Sandvik¹,

Rosendal²,

Doorn³

et al. 2014

TONEUROSJ

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Abstract:Background: DBS (deep brain stimulation) is currently the golden standard in the surgical treatment of ET (essential tremor). Despite the benefits of DBS, there remain situations where lesional surgery may provide an alternative.Objective: To perform a very long-term retrospective evaluation of thalamotomies for ET.Methods: Nine patients who underwent thalamotomy for ET during 1972-1999 (follow-up period 20.8±5.2 years) were assessed with regard to tremor scores, side effects, and quality of life, as well as lesion size and location.Results: All patients had tremor recurrence, although handfunction remained slightly better on the treated side than on the non-treated side. Side effects that could be attributed to the procedure were frequent and did in some cases result in a disability for the patient. Quality of life was poorer in this group than in an age-adjusted healthy population. No correlation between lesion size, location, and long-term outcome could be established. Conclusions:In this study population the benefits of thalamotomies were limited, while complications were frequent.

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“…Medications are often considered to be effective in only 50% of patients [2]. When the disorder becomes resistant to medication, surgical options for such patients are either ablative procedures such as thalamotomy [17,18] or DBS [19]. Although thalamic DBS has been shown to be a safe and effective therapy in ET patients followed for up to 13 years [20], ET cases exist where DBS failed to produce symptomatic or functional improvement.…”

Section: Introductionmentioning

confidence: 99%

Effects of Cerebellothalamic Tractotomy on Cognitive and Emotional Functioning in Essential Tremor: A Preliminary Study in 5 Essential Tremor Patients

Ledermann¹,

Jeanmonod

McAleese

et al. 2015

Stereotact Funct Neurosurg

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Background: Subthalamic stereotactic interventions have recently caught renewed interest as a treatment for essential tremor (ET). However, it is not clear whether these interventions are associated with neurocognitive, mood or personality changes. Objective: To investigate neurocognition, neuropsychiatric functions and personality variables in patients with ET and to explore the neurocognitive and neuropsychiatric effects of cerebellothalamic tractotomy (CTT), a form of subthalamotomy. Methods: In our study, we investigated cognitive functions, frontal functions, mood and personality variables in 5 patients with intractable ET. Patients were tested before and 3 months after surgery using neuropsychological tests, clinical scales for depression, anxiety, anger regulation and a personality test. Results: Before surgery, ET patients showed normal neurocognitive function, a slightly elevated frontal lobe score in the dimensions mental control and memory, without being indicative of a frontal lesion, and no elevated depression or anxiety scores compared to norm values. After surgery, there was no change in neurocognitive function and no increase in depression or anxiety scores. Conclusion: In this exploratory study on 5 ET patients, CTT was not associated with alterations of mood or neurocognitive functions.

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Long-Term Results of Stereotaxy in the Treatment of Essential Tremor

Cited by 81 publications

References 9 publications

Stereotactic Ventral Intermedial Thalamotomy for the Treatment of Essential Tremor:Results of a Series of 37 Patients

Stereotactic Ventral Intermedial Thalamotomy for the Treatment of Essential Tremor:Results of a Series of 37 Patients

Thalamotomy for Essential Tremor: A Very Long-Term Follow-Up

Effects of Cerebellothalamic Tractotomy on Cognitive and Emotional Functioning in Essential Tremor: A Preliminary Study in 5 Essential Tremor Patients

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