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PMID: 9307249: Thalamic Stimulation and tremor 53/1 USA 1997

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High-frequency unilateral thalamic stimulation
in the treatment of essential and parkinsonian tremor.
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Pharmacologic treatment for essential tremor and the tremor of Parkinson's
disease is often inadequate.

Stereotaxic surgery, such as thalamotomy, can effectively reduce tremors.

We performed a multicenter trial of unilateral high-frequency stimulation
of the ventral intermedius nucleus of the thalamus in 29 patients with
essential tremor and 24 patients with Parkinson's disease, using a blinded
assessment at 3 months after surgery to compare clinical rating of tremor
with stimulation ON with stimulation OFF and baseline and a 1-year follow-up.

Six patients were not implanted because of lack of intraoperative tremor
suppression (2 patients), hemorrhage (2 patients), withdrawal of consent (1
patient), and persistent microthalamotomy effect (1 patient).

A significant reduction in both essential and parkinsonian tremor occurred
contralaterally with stimulation.

Patients reported a significant reduction in disability.

Measures of function were significantly improved in patients with essential
tremor.

Complications related to surgery in implanted patients were few.

Stimulation was commonly associated with transient paresthesias.

Other adverse effects were mild and well tolerated.

Efficacy was not reduced at 1 year.

Chronic high-frequency stimulation is safe and highly effective in
ameliorating essential and parkinsonian tremor.


Ann Neurol 1997 Sep;42(3):292-299
Koller W, Pahwa R, Busenbark K, Hubble J, Wilkinson S, Lang A,
Tuite P, Sime E, Lazano A, Hauser R, Malapira T, Smith D, Tarsy D,
Miyawaki E, Norregaard T, Kormos T, Olanow CW
University of Kansas Medical Center, Kansas City, Kansas 66160 USA
PMID: 9307249, MUID: 97450808
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janet paterson/50/9/sinemet/selegiline/prozac/paterson@xxxxxx/bermuda


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