title: Ventral intermediate thalamic stimulation for monoclonal gammopathy-associated tremor: case report.
abstract: BACKGROUND
  Peripheral and central sensory loss are often associated with significant tremor or sensory ataxia, which can be highly refractory to medical therapy.
  
  
  METHODS
  We present the case of a 67-year-old man with progressive and debilitating intention tremor from monoclonal gammopathy-associated peripheral neuropathy. The patient was implanted with bilateral thalamic deep brain stimulator electrodes under microelectrode guidance. Following optimization of stimulation parameters, the patient's appendicular tremor and gait improved, as did his general activities of daily living.
  
  
  CONCLUSIONS
  These initial findings suggest that deep brain stimulation may benefit not only tremor presumed to originate from central nervous system dysfunction, but also tremor originating peripherally from neuropathy-related sensory loss.
authors.affiliation: Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Donald C
authors.initials: DC
authors.lastname: Shields
authors.forename: Alice W
authors.initials: AW
authors.lastname: Flaherty
authors.forename: Emad N
authors.initials: EN
authors.lastname: Eskandar
authors.forename: Ziv M
authors.initials: ZM
authors.lastname: Williams
mesh_terms: D000368:Aged; D046690:Deep Brain Stimulation / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010265:Paraproteinemias / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D014202:Tremor / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D020651:Ventral Thalamic Nuclei