Surgical treatment of essential tremor
- Daniel Tarsy, MD
Daniel Tarsy, MD
- Professor of Neurology
- Harvard Medical School
- Ludy Shih, MD
Ludy Shih, MD
- Assistant Professor of Neurology
- Harvard Medical School
Tremor is defined as a rhythmic and oscillatory movement of a body part with a relatively constant frequency and variable amplitude. It is caused by either alternating or synchronous contractions of antagonistic muscles. Tremor is the most common of all movement disorders, and essential tremor (ET) is the most common neurologic cause of postural or action tremor.
The criteria for ET and methods for distinguishing this from other tremors are shown in the tables (table 1 and table 2 and table 3). (See "Overview of tremor", section on 'Essential tremor'.)
Deep brain stimulation of the ventral intermediate nucleus of the thalamus and stereotactic thalamotomy appear to be effective treatments for severely disabling, medication-resistant ET.
This topic will review the surgical treatment of ET. The pharmacologic treatment of ET is discussed separately. (See "Treatment and prognosis of essential tremor".)
The classification, clinical features, and evaluation of the major types of tremor are discussed separately. (See "Overview of tremor".)
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- DEEP BRAIN STIMULATION
- Effectiveness of DBS for limb tremor
- Effectiveness of DBS for voice and head tremor
- Limitations of DBS
- Effectiveness of thalamotomy
- Limitations of thalamotomy
- Gamma knife thalamotomy
- Ultrasound thalamotomy
- COMPARISON OF THALAMOTOMY AND DBS
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS