Long-term suppression of tremor by deep brain stimulation of the ventral intermediate nucleus of the thalamus combined with pallidotomy in hemiparkinsonian patients.
Deep brain stimulation (DBS) of the ventral intermediate nucleus of the thalamus (VIM) is a powerful surgical option in the treatment of tremor-predominant Parkinson's disease. However, its therapeutic efficacy depends on the tremor distribution. DBS is highly efficient in relief of distal appendicular tremor but not other types of tremor. Also, it is generally thought that DBS of the VIM has no significant beneficial effects on other motor symptoms of Parkinson's disease. We report two hemiparkinsonian patients, in whom unilateral VIM DBS combined with posteroventral pallidotomy produced long-lasting suppression of not only hand tremor, but also leg or jaw tremor and other motor symptoms.
Nishio
Masami
M
Department of Neurosurgery, Otemae Hospital, Osaka, Japan.
Korematsu
Kojiro
K
Yoshioka
Susumu
S
Nagai
Yasuyuki
Y
Maruo
Tomoyuki
T
Ushio
Yukitaka
Y
Kaji
Ryuji
R
Goto
Satoshi
S
D000368:Aged; D046690:Deep Brain Stimulation / Q000379:methods*; D007839:Functional Laterality / Q000502:physiology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D020644:Midline Thalamic Nuclei / Q000502:physiology*; D053860:Pallidotomy / Q000379:methods*; D010300:Parkinson Disease / Q000150:complications / Q000628:therapy*; D014202:Tremor / Q000209:etiology / Q000628:therapy*