Thalamic deep brain stimulation for disabling tremor after excision of a midbrain cavernous angioma. Case report.
Thalamic deep brain stimulation (DBS) has been demonstrated to be effective for the treatment of parkinsonian or essential tremor. To date, however, few data exist to support the application of this method to treat midbrain tremor. A 24-year-old right-handed man underwent radiosurgery and subsequent resection of a recurrently hemorrhaging cavernous angioma located in the left side of the midbrain. The surgery exacerbated severe choreoathetotic resting and action tremors of his right extremities and trunk. The patient underwent placement of a deep brain stimulator into the left ventral intermediate nucleus of the thalamus (Vim). Postoperatively, decreased truncal ataxia and right-sided choreoathetotic tremor were demonstrated, with a 57% increase in dexterity as measured by task testing. The authors demonstrate that DBS can be an effective treatment modality for disabling tremor after resection of a midbrain cavernous angioma.
Samadani
Uzma
U
Department of Neurosurgery and Neurology, Penn Neurological Institute at Pennsylvania Hospital, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 19107, USA.
Umemura
Atsushi
A
Jaggi
Jurg L
JL
Colcher
Amy
A
Zager
Eric L
EL
Baltuch
Gordon H
GH
D000328:Adult; D004599:Electric Stimulation Therapy / Q000295:instrumentation* / Q000379:methods; D006392:Hemangioma, Cavernous / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008636:Mesencephalon / Q000473:pathology / Q000601:surgery*; D013788:Thalamus / Q000502:physiology*; D014202:Tremor / Q000209:etiology* / Q000628:therapy*