Should we consider Vim thalamic deep brain stimulation for select cases of severe refractory dystonic tremor.
Dystonic tremor, which may present with many different clinical presentations (rhythmic oscillations, abnormal posture, pain, and/or a null point) has proven to be a challenge for the clinician to effectively treat. Although recent studies have demonstrated excellent outcomes in select cases following deep brain stimulation (DBS) of the internal globus pallidus, the optimal target for dystonia and particularly for dystonic tremor remains unknown. We report 3 cases of dystonic tremor which were successfully addressed through the use of ventral intermediate nucleus (Vim) DBS. We also review the literature concerning the efficacy of Vim DBS for addressing dystonia. This case series illustrates the potential use of Vim DBS for select cases of dystonic tremor.
Morishita
Takashi
T
Department of Neurology, University of Florida College of Medicine/Shands Hospital, Movement Disorders Center, McKnight Brain Institute, Gainesville, FL 32610, USA. takashi.morishita@neurology.ufl.edu
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Kelly D
KD
Haq
Ihtsham U
IU
Zeilman
Pamela
P
Jacobson
Charles E
CE
Okun
Michael S
MS
D000328:Adult; D000368:Aged; D016208:Databases, Factual; D046690:Deep Brain Stimulation / Q000379:methods; D020821:Dystonic Disorders / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D014202:Tremor / Q000503:physiopathology / Q000628:therapy*; D020651:Ventral Thalamic Nuclei / Q000502:physiology*