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

Deep brain stimulation (DBS) is a common surgical procedure used for the treatment of Parkinson's disease (PD) and essential tremor. A potential complication of this procedure is hardware failure. The authors report a case of DBS hardware failure in which repeated fractures of the extension wire were caused by abnormal rotational movements of the IPG placed in the loose subclavicular tissue of an overweight female. Implantation of the IPG in the suprascapular area prevented further extension wire fractures. This strategy may be especially relevant in overweight females with loose subclavicular tissue.

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Cost-Minimisation Analysis of MR-GUIDED Focused Ultrasound Therapy Compared to Deep Brain Stimulation in Patients with Essential Tremor

Value in Health ◽

10.1016/j.jval.2018.07.525 ◽

2018 ◽

Vol 21 ◽

pp. S69-S70

Author(s):

A Igarashi ◽

M Tanaka ◽

K Abe ◽

R Lance ◽

K Yamada

Keyword(s):

Deep Brain Stimulation ◽

Essential Tremor ◽

Brain Stimulation ◽

Focused Ultrasound ◽

Ultrasound Therapy ◽

Cost Minimisation Analysis ◽

Cost Minimisation ◽

Deep Brain

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Deep brain stimulation of the centromedian thalamic nucleus for essential tremor: a case report

Acta Neurochirurgica ◽

10.1007/s00701-017-3143-y ◽

2017 ◽

Vol 159 (5) ◽

pp. 789-793 ◽

Cited By ~ 2

Author(s):

Vibhash D. Sharma ◽

Klaus Mewes ◽

Thomas Wichmann ◽

Cathrin Buetefisch ◽

Jon T. Willie ◽

...

Keyword(s):

Case Report ◽

Deep Brain Stimulation ◽

Essential Tremor ◽

Brain Stimulation ◽

Thalamic Nucleus ◽

Deep Brain ◽

Stimulation Of

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Treatment of essential tremor: current status

Postgraduate Medical Journal ◽

10.1136/postgradmedj-2019-136647 ◽

2019 ◽

Vol 96 (1132) ◽

pp. 84-93 ◽

Cited By ~ 2

Author(s):

Soumya Sharma ◽

Sanjay Pandey

Keyword(s):

Deep Brain Stimulation ◽

Essential Tremor ◽

Brain Stimulation ◽

Focused Ultrasound ◽

Current Status ◽

Surgical Interventions ◽

Dystonic Posturing ◽

Consensus Classification ◽

Botulinum Toxin Injections ◽

Deep Brain

Essential tremor is the most common cause of tremor involving upper limbs, head and voice. The first line of treatment for limb tremor is pharmacotherapy with propranolol or primidone. However, these two drugs reduce the tremor severity by only half. In medication refractory and functionally disabling tremor, alternative forms of therapy need to be considered. Botulinum toxin injections are likely efficacious for limb, voice and head tremor but are associated with side effects. Surgical interventions include deep brain stimulation; magnetic resonance-guided focused ultrasound and thalamotomy for unilateral and deep brain stimulation for bilateral procedures. Recent consensus classification for essential tremor has included a new subgroup, ‘Essential tremor plus’, who have associated subtle neurological ‘soft signs’, such as dystonic posturing of limbs and may require a different treatment approach. In this review, we have addressed the current management of essential tremor with regard to different anatomical locations of tremor as well as different modalities of treatment.

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