eMedicine Specialties > Neurology > Movement and Neurodegenerative Diseases

Surgical Treatment of Tremor: Multimedia

Author: Michele Tagliati, MD, Division Chief of Movement Disorders, Associate Professor, Department of Neurology, Mount Sinai School of Medicine
Coauthor(s): Ron L Alterman, MD, Associate Professor of Neurosurgery, Mount Sinai School of Medicine; Consulting Surgeon, Department of Neurosurgery, Mount Sinai School of Medicine, Elmhurst Hospital, and Walter Reed Army Medical Center
Contributor Information and Disclosures

Updated: May 15, 2006

Multimedia

Surgical treatment of tremor. Sagittal section th...Media file 1: Surgical treatment of tremor. Sagittal section through the thalamus demonstrating the ventrocaudal (green), ventral intermediate (red), ventral oral posterior (dark blue), and ventral oralis anterior (light blue) nuclei. Thalamic stimulators and thalamotomies to treat tremor are placed at the junction of the ventral intermediate and ventral oral posterior nuclei.
Surgical treatment of tremor. Sagittal section th...

Surgical treatment of tremor. Sagittal section through the thalamus demonstrating the ventrocaudal (green), ventral intermediate (red), ventral oral posterior (dark blue), and ventral oralis anterior (light blue) nuclei. Thalamic stimulators and thalamotomies to treat tremor are placed at the junction of the ventral intermediate and ventral oral posterior nuclei.

Surgical treatment of tremor. Axial fast spin ech...Media file 2: Surgical treatment of tremor. Axial fast spin echo inversion recovery MRI at the level of the posterior commissure. The typical target for placing a thalamic stimulator is demonstrated (crosshairs).
Surgical treatment of tremor. Axial fast spin ech...

Surgical treatment of tremor. Axial fast spin echo inversion recovery MRI at the level of the posterior commissure. The typical target for placing a thalamic stimulator is demonstrated (crosshairs).

Surgical treatment of tremor. The deep brain stim...Media file 3: Surgical treatment of tremor. The deep brain stimulation lead is equipped with 4 electrode contacts, each of which may be employed, alone or in combination, for therapeutic stimulation.
Surgical treatment of tremor. The deep brain stim...

Surgical treatment of tremor. The deep brain stimulation lead is equipped with 4 electrode contacts, each of which may be employed, alone or in combination, for therapeutic stimulation.

Surgical treatment of tremor. Deep brain stimulat...Media file 4: Surgical treatment of tremor. Deep brain stimulation parameters can be adjusted at any time using a transcutaneous programmer.
Surgical treatment of tremor. Deep brain stimulat...

Surgical treatment of tremor. Deep brain stimulation parameters can be adjusted at any time using a transcutaneous programmer.

More on Surgical Treatment of Tremor

References

References

  1. Alesch F, Pinter MM, Helscher RJ, et al. Stimulation of the ventral intermediate thalamic nucleus in tremor dominated Parkinson''s disease and essential tremor. Acta Neurochir (Wien). 1995;136(1-2):75-81. [Medline].

  2. Deuschl G, Elble RJ. The pathophysiology of essential tremor. Neurology. 2000;54(11 Suppl 4):S14-20. [Medline].

  3. Dowsey-Limousin P. Postoperative management of Vim DBS for tremor. Mov Disord. 2002;17 Suppl 3:S208-11. [Medline].

  4. Elble RJ. Diagnostic criteria for essential tremor and differential diagnosis. Neurology. 2000;54(11 Suppl 4):S2-6. [Medline].

  5. Lenz FA, Kwan HC, Martin RL, et al. Single unit analysis of the human ventral thalamic nuclear group. Tremor-related activity in functionally identified cells. Brain. Jun 1994;117 ( Pt 3):531-43. [Medline].

  6. Limousin P, Speelman JD, Gielen F. Multicentre European study of thalamic stimulation in parkinsonian and essential tremor. J Neurol Neurosurg Psychiatry. Mar 1999;66(3):289-96. [Medline].

  7. Limousin P. '. 2002.

  8. McIntyre CC, Savasta M, Kerkerian-Le Goff L. Uncovering the mechanism(s) of action of deep brain stimulation: activation, inhibition, or both. Clin Neurophysiol. Jun 2004;115(6):1239-48. [Medline].

  9. Mohadjer M, Goerke H, Milios E, et al. Long-term results of stereotaxy in the treatment of essential tremor. Stereotact Funct Neurosurg. 1990;54-55:125-9. [Medline].

  10. Pahwa R, Lyons K, Koller WC. Surgical treatment of essential tremor. Neurology. 2000;54(11 Suppl 4):S39-44. [Medline].

  11. Rodriguez MC, Guridi OJ, Alvarez L, et al. The subthalamic nucleus and tremor in Parkinson''s disease. Mov Disord. 1998;13 Suppl 3:111-8. [Medline].

  12. Sydow O, Thobois S, Alesch F. Multicentre European study of thalamic stimulation in essential tremor: a six year follow up. J Neurol Neurosurg Psychiatry. Oct 2003;74(10):1387-91. [Medline].

  13. Tasker RR. Movement disorders. In: Brain Surgery Complication Avoidance and Management. New York: Churchill Livingstone;1993:1509.

Further Reading

Keywords

deep brain stimulation, DBS, movement disorder, neurosurgery, stereotactic surgery, stereotaxis, thalamotomy, surgery for tremor, surgical treatment of tremor, Parkinson disease, PD, Parkinson's disease, parkinsonian symptoms

Contributor Information and Disclosures

Author

Michele Tagliati, MD, Division Chief of Movement Disorders, Associate Professor, Department of Neurology, Mount Sinai School of Medicine
Michele Tagliati, MD is a member of the following medical societies: American Academy of Neurology, American Medical Association, and Movement Disorders Society
Disclosure: Nothing to disclose.

Coauthor(s)

Ron L Alterman, MD, Associate Professor of Neurosurgery, Mount Sinai School of Medicine; Consulting Surgeon, Department of Neurosurgery, Mount Sinai School of Medicine, Elmhurst Hospital, and Walter Reed Army Medical Center
Disclosure: Nothing to disclose.

Medical Editor

Robert A Hauser, MD, Professor, Departments of Neurology, Pharmacology, and Experimental Therapeutics, Director, Parkinson's Disease and Movement Disorders Center, University of South Florida and Tampa General Healthcare
Robert A Hauser, MD is a member of the following medical societies: American Academy of Neurology and Movement Disorders Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Nestor Galvez-Jimenez, MD, Program Director of Movement Disorders, Department of Neurology, Division of Medicine, Director of Neurology Residency Training Program, Cleveland Clinic Florida
Nestor Galvez-Jimenez, MD is a member of the following medical societies: American Academy of Neurology, American College of Physicians, and Movement Disorders Society
Disclosure: Nothing to disclose.

CME Editor

Selim R Benbadis, MD, Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, University of South Florida School of Medicine, Tampa General Hospital
Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Nicholas Y Lorenzo, MD, Chief Editor, eMedicine Neurology; Consulting Staff, Neurology Specialists and Consultants
Nicholas Y Lorenzo, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Neurology
Disclosure: Nothing to disclose.

 
 
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