title: Deep brain stimulation for the treatment of uncommon tremor syndromes.
abstract: Deep brain stimulation (DBS) has become a standard therapy for the treatment of select cases of medication refractory essential tremor and Parkinson's disease however the effectiveness and long-term outcomes of DBS in other uncommon and complex tremor syndromes has not been well established. Traditionally, the ventralis intermedius nucleus (VIM) of the thalamus has been considered the main target for medically intractable tremors; however alternative brain regions and improvements in stereotactic techniques and hardware may soon change the horizon for treatment of complex tremors.
  
  
  
  In this article, we conducted a PubMed search using different combinations between the terms 'Uncommon tremors', 'Dystonic tremor', 'Holmes tremor' 'Midbrain tremor', 'Rubral tremor', 'Cerebellar tremor', 'outflow tremor', 'Multiple Sclerosis tremor', 'Post-traumatic tremor', 'Neuropathic tremor', and 'Deep Brain Stimulation/DBS'. Additionally, we examined and summarized the current state of evolving interventions for treatment of complex tremor syndromes. Expert commentary: Recently reported interventions for rare tremors include stimulation of the posterior subthalamic area, globus pallidus internus, ventralis oralis anterior/posterior thalamic subnuclei, and the use of dual lead stimulation in one or more of these targets. Treatment should be individualized and dictated by tremor phenomenology and associated clinical features.
authors.affiliation: a Department of Neurology , Albany Medical College , Albany NY , USA.
authors.forename: Adolfo
authors.initials: A
authors.lastname: Ramirez-Zamora
authors.affiliation: b Department of Neurology , University of Florida Center for Movement Disorders and Neurorestoration , Gainesville FL , USA.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Okun
mesh_terms: D046690:Deep Brain Stimulation; D020329:Essential Tremor; D005917:Globus Pallidus; D006801:Humans; D013577:Syndrome; D016896:Treatment Outcome; D014202:Tremor
keywords: Deep brain stimulation; Holmes tremor; cerebellar tremor; complex tremor syndromes; dystonic tremor; multiple sclerosis tremor; post-traumatic tremor