scholarly journals Coaxial interleaved stimulation of the thalamus and subthalamus for treatment of Holmes tremor

2017 ◽  
Vol 42 (videosuppl2) ◽  
pp. V1 ◽  
Author(s):  
Hiroki Toda ◽  
Namiko Nishida ◽  
Koichi Iwasaki
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Novel Technique ◽  
Link Type ◽  
Holmes Tremor ◽  
Deep Brain ◽  
Stimulation Of

Holmes tremor is often treated with multiple deep brain stimulation (DBS) electrodes. The authors describe a novel technique to suppress the tremors by effectively utilizing a single electrode.A 16-year-old boy presented with severe right arm tremor following a midbrain injury. A DBS electrode was implanted into the ventral oralis nucleus of the thalamus (VO) and the subthalamic region. While individual stimulation of each target was ineffective, an interleaved dual stimulation of both targets has been effective for 6 years.Coaxial interleaved stimulation of the VO and the subthalamic region is useful for treating Holmes tremor.The video can be found here: https://youtu.be/tSwGh3vy68c.

Possible necessity for deep brain stimulation of both the ventralis intermedius and subthalamic nuclei to resolve Holmes tremor

2003 ◽  
Vol 99 (3) ◽  
pp. 566-571 ◽  
Author(s):  
Pantaleo Romanelli ◽  
Helen Bronté-Stewart ◽  
Tracy Courtney ◽  
Gary Heit
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Clinical Observation ◽  
Intention Tremor ◽  
Content Type ◽  
Resting Tremor ◽  
Holmes Tremor ◽  
Tremor Analysis ◽  
Deep Brain ◽  
Stimulation Of

✓ Holmes tremor is characterized by resting, postural, and intention tremor. Deep brain stimulation (DBS) of both the nucleus ventralis intermedius (Vim) and the subthalamic nucleus (STN) may be required to control these three tremor components. A 79-year-old man presented with a long-standing combination of resting, postural, and intention tremor, which was associated with severe disability and was resistant to medical treatment. Neuroimaging studies failed to reveal areas of discrete brain damage. A DBS device was placed in the Vim and produced an improvement in both the intention and postural tremor, but there was residual resting tremor, as demonstrated by clinical observation and quantitative tremor analysis. Placement of an additional DBS device in the STN resolved the resting tremor. Stimulation of the Vim or STN alone failed to produce global resolution of mixed tremor, whereas combined Vim—STN stimulation produced global relief without creating noticeable side effects. Combined Vim—STN stimulation can thus be a safe and effective treatment for Holmes tremor.

Deep brain stimulation of the globus pallidus internus or ventralis intermedius nucleus of thalamus for Holmes tremor

2015 ◽  
Vol 38 (4) ◽  
pp. 753-763 ◽  
Author(s):  
Jairo Alberto Espinoza Martinez ◽  
Gabriel J. Arango ◽  
Erich Talamoni Fonoff ◽  
Thomas Reithmeier ◽  
Oscar Andrés Escobar ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Globus Pallidus ◽  
Brain Stimulation ◽  
Globus Pallidus Internus ◽  
Holmes Tremor ◽  
Deep Brain ◽  
Stimulation Of

scholarly journals Deep brain stimulation of the nucleus ventralis intermedius for Holmes (rubral) tremor and associated dystonia caused by upper brainstem lesions

2004 ◽  
Vol 17 (1) ◽  
pp. 1079-1083
Author(s):  
Guido Nikkhah ◽  
Thomas Prokop ◽  
Bernhard Hellwig ◽  
Carl Hermann Lücking ◽  
Christoph B. Ostertag
Keyword(s):  
Deep Brain Stimulation ◽  
Medical Therapy ◽  
Brain Stimulation ◽  
Thalamic Nucleus ◽  
Unilateral Stimulation ◽  
Holmes Tremor ◽  
Rubral Tremor ◽  
Associated Symptoms ◽  
Deep Brain ◽  
Stimulation Of

✓Holmes tremor is caused by structural lesions in the perirubral area of the midbrain. Patients often present with associated symptoms such as dystonia and paresis, which are usually refractory to medical therapy. Here, the authors describe two patients in whom both tremor and associated dystonia improved markedly following unilateral stimulation of the thalamic nucleus ventralis intermedius.

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