title: Clinical cases where lesion therapy was chosen over deep brain stimulation.
abstract: Deep brain stimulation (DBS) surgery has become the gold standard for treatment of select refractory cases of Parkinson disease and essential tremor. Despite the usefulness of DBS surgery in many cases, there remain situations where lesion therapy (subthalamotomy, pallidotomy or thalamotomy) may provide a reasonable alternative to DBS. We reviewed the University of Florida Institutional Review Board-approved database for movement disorders surgery and identified 286 DBS leads placed in 189 patients as well as 4 additional patients who had lesion therapy. In these 4 cases we reviewed the clinical presentations that resulted in a multidisciplinary team opting for lesion therapy over DBS. Lesion therapy represents a viable alternative and has several important advantages, including a decreased need for access to specialists and clinical follow-up, improved affordability, and a lower infection risk.
authors.affiliation: University of Florida, Movement Disorders Center, Gainesville, FL 32601, USA. akhooper@ufl.edu
authors.forename: Amanda K
authors.initials: AK
authors.lastname: Hooper
authors.forename: Michael S
authors.initials: MS
authors.lastname: Okun
authors.forename: Kelly D
authors.initials: KD
authors.lastname: Foote
authors.forename: Hubert H
authors.initials: HH
authors.lastname: Fernandez
authors.forename: Charles
authors.initials: C
authors.lastname: Jacobson
authors.forename: Pamela
authors.initials: P
authors.lastname: Zeilman
authors.forename: Janet
authors.initials: J
authors.lastname: Romrell
authors.forename: Ramon L
authors.initials: RL
authors.lastname: Rodriguez
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D046690:Deep Brain Stimulation / Q000009:adverse effects / Q000379:methods*; D020329:Essential Tremor / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000473:pathology / Q000601:surgery; D053860:Pallidotomy / Q000009:adverse effects / Q000379:methods*; D010300:Parkinson Disease / Q000473:pathology / Q000601:surgery; D013238:Stereotaxic Techniques / Q000009:adverse effects