[Thalamic neuro inhibition in the treatment of post traumatic tremor].
BACKGROUND
Severe head trauma could be followed by a wide range of movement disorders. Usually, they appear as a moderate or severe intention tremor that causes great patient disability. Those movement disorders use to be refractary to medical treatment, although sometimes they would be spontaneusly controlled by a year.


METHODS
14 year old boy who suffered severe head trauma at age of 8. One year after the injury he developed an action tremor and choreiform dyskinesia with hemibalistic features evocated by the movement. Medical treatment was ineffective. Due to the great patients disability, we chose the surgical treatment based on the placement of an stimulation electrode in thalamic Vop/Vim complex, obtaining a tremor abolition with an improvement in the scales of tremor and quality of life.


CONCLUSIONS
Surgical treatment of postraumatic tremors tryes to improve in terms of function and activities of daily living, more than suppresion of a symptom. The aim of this treatment is cut the palidal thalamic cortical pathways. Anyway, target is defined by the tremor related cells and, it is more a functional target than an anatomical one. We prefer stimulation more than lesion, due to the lack of brain definitive injury because its reversibility and adjustability features.
Martínez-Mañas
R
R
Servicio de NeurocirugInstitut Clínic de Malalties del SN, Barcelona, 08036, España. 29256rmm@comb.es
Rumià
J
J
Valldeoriola
F
F
Ferrer
E
E
Tolosa
E
E
D000293:Adolescent; D001921:Brain / Q000473:pathology / Q000601:surgery; D001930:Brain Injuries / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D005917:Globus Pallidus / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009433:Neural Inhibition / Q000502:physiology*; D009434:Neural Pathways / Q000503:physiopathology / Q000601:surgery; D013238:Stereotaxic Techniques; D013788:Thalamus / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D014202:Tremor / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery