| Comparison of Thalamotomy and Deep Brain Stimulation in Patients with Parkinsonian Tremor |
|
Hyun Gon Lee, Moo Seong Kim, Won Hee Lee, Seong Tae Kim, Se Young Pyo, Yang Won Kim |
|
Department of Neurosurgery, Inje University Busan Paik Hospital, Busan, Korea Department of Emergency Medicine, Inje University Busan Paik Hospital, Busan, Korea |
|
|
| Abstract |
Objective
Tremors, either essential or parkinsonian, have been effectively and safely treated with GammaKnife (GK) radiosurgery, radiofrequency (RF) lesioning, or deep brain stimulation (DBS). The authors evaluated treatment outcomes after RF thalamotomy, GK thalamotomy, or DBS in the Vim thalamic nucleus in patients with parkinsonian tremor.
Methods
Between September 2001 and December 2011, 22 patients with parkinsonian tremor were treated with RF thalamotomy (12 patients), GK thalamotomy (5 patients), or Vim-DBS (5 patients) in our institute. The male to female ratio was 1.6 to 1 with a median age of 59.6 years (range : 39-74 years). Pre- and post-operative tremor was evaluated with a simple tremor severity scale, the United Parkinson's disease Rating Scale tremor score, and the development of complications that were related to the procedure was closely reviewed from the immediate postoperative period to the last follow up examination.
Results
RF thalamotomies completely abolished tremor in 58.3% of the patients and almost abolished it in 33.3% of the patients. DBS completely abolished tremor in 40% of the patients and almost abolished it in 60%. GK thalamotomies completely abolished tremor in 80% of the patients and mildly abolished it in 20% of the patients. There were no complications that were related to the procedures.
Conclusion
Vim thalamotomies are a safe and effective procedure for the control of tremor. DBS is very beneficial in treating patients with bilateral intractable tremor. GK thalamotomies are suitable for patients with intractable unilateral tremor due to factors, including medical disease, old age, and coagulopathy. |
| Key Words:
Tremor, Thalamotomy, Radiofrequency, Deep brain stimulation, Gamma Knife radiosurgery. |
|
PDF Links
Full text via DOI
Download Citation
