[Functional surgery of the thalamus in movement disorders].
BACKGROUND
Functional thalamic surgery as a treatment for movement disorders is half a century old. Although the accumulated experience is wide, their precise indications have varied depending on the available alternative therapies.


METHODS
In this article the historical evolution, anatomofunctional basis and results of the functional surgery on the motor thalamus are reviewed. Considering new advances in this field, the current indications are proposed.


CONCLUSIONS
Nowadays, thalamic surgery is a valuable therapeutic option for patients with different tremor syndromes, when the upper limb tremor is disabling, and satisfactory relief with pharmacological treatment cannot be achieved. It can also be useful in selected patients with ballism and with secondary hemidystonia. When unilateral surgery is considered, both thalamotomy and thalamic stimulation can be acceptably safe and effective procedures in experienced surgical teams. The main advantage of stimulation is its irreversibility, making possible bilateral procedures with a lower morbidity. The objective of surgery should be to improve the patients' functional capacities and quality of life, therefore, the indication and selection of the procedure should be individualized.
Mínguez
A
A
Servicio de Neurología, Hospital Virgen de las Nieves, Granada, España. aminguezc@meditex.es
D006801:Humans; D009069:Movement Disorders / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods*; D013788:Thalamus / Q000601:surgery*