Thalamotomy as a Treatment Option for Tremor after Ineffective Deep Brain Stimulation

Diaa Bahgat, Stephen T. Magill, Caglar Berk, Shirley McCartney, Kim Burchiel

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background: As the number of deep brain stimulation (DBS) surgeries increases, complications from malpositioned electrodes, tolerance to stimulation and loss of efficacy have also increased. Our objective was to assess thalamotomy as a salvage treatment option after ineffective DBS. Methods: A retrospective chart analysis of patients who underwent ipsilateral stereotactic thalamotomy after an ineffective ventrointermediate nucleus DBS procedure was undertaken. Patient outcome was based on follow-up visit chart notes, and a nonvalidated patient telephone questionnaire to assess patients' perception of tremor and functional ability after thalamotomy. Results: Six patients with essential tremor and 1 with tremor-predominant Parkinson's disease met our inclusion criteria. Thalamotomies were undertaken for ineffective DBS due to dysarthria and paresthesias with programming in 2 patients, tremor that failed to respond to increased DBS despite a lack of side effects in 2 patients, malpositioned electrode in 2 patients, and sudden loss of DBS efficacy following eye surgery in 1 patient. Following thalamotomy, 3 patients reported improvement in symptoms and function, 3 patients reported improvement in symptoms that were not reflected in functional improvement, and 1 patient reported no improvement in symptoms or function. Conclusion: Thalamotomy may provide a viable salvage solution in patients who fail to respond to DBS due to complications such as malpositioned electrodes, tolerance to stimulation or loss of efficacy.

Original languageEnglish (US)
Pages (from-to)18-23
Number of pages6
JournalStereotactic and Functional Neurosurgery
Volume91
Issue number1
DOIs
StatePublished - Jan 2013

Fingerprint

Deep Brain Stimulation
Tremor
Therapeutics
Electrodes
Essential Tremor
Salvage Therapy
Dysarthria
Aptitude
Paresthesia
Telephone
Parkinson Disease

Keywords

  • Deep brain stimulation
  • Thalamotomy
  • Tremor

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Thalamotomy as a Treatment Option for Tremor after Ineffective Deep Brain Stimulation. / Bahgat, Diaa; Magill, Stephen T.; Berk, Caglar; McCartney, Shirley; Burchiel, Kim.

In: Stereotactic and Functional Neurosurgery, Vol. 91, No. 1, 01.2013, p. 18-23.

Research output: Contribution to journalArticle

@article{8f7614823d0041d59593b5c7f744fdd9,
title = "Thalamotomy as a Treatment Option for Tremor after Ineffective Deep Brain Stimulation",
abstract = "Background: As the number of deep brain stimulation (DBS) surgeries increases, complications from malpositioned electrodes, tolerance to stimulation and loss of efficacy have also increased. Our objective was to assess thalamotomy as a salvage treatment option after ineffective DBS. Methods: A retrospective chart analysis of patients who underwent ipsilateral stereotactic thalamotomy after an ineffective ventrointermediate nucleus DBS procedure was undertaken. Patient outcome was based on follow-up visit chart notes, and a nonvalidated patient telephone questionnaire to assess patients' perception of tremor and functional ability after thalamotomy. Results: Six patients with essential tremor and 1 with tremor-predominant Parkinson's disease met our inclusion criteria. Thalamotomies were undertaken for ineffective DBS due to dysarthria and paresthesias with programming in 2 patients, tremor that failed to respond to increased DBS despite a lack of side effects in 2 patients, malpositioned electrode in 2 patients, and sudden loss of DBS efficacy following eye surgery in 1 patient. Following thalamotomy, 3 patients reported improvement in symptoms and function, 3 patients reported improvement in symptoms that were not reflected in functional improvement, and 1 patient reported no improvement in symptoms or function. Conclusion: Thalamotomy may provide a viable salvage solution in patients who fail to respond to DBS due to complications such as malpositioned electrodes, tolerance to stimulation or loss of efficacy.",
keywords = "Deep brain stimulation, Thalamotomy, Tremor",
author = "Diaa Bahgat and Magill, {Stephen T.} and Caglar Berk and Shirley McCartney and Kim Burchiel",
year = "2013",
month = "1",
doi = "10.1159/000342491",
language = "English (US)",
volume = "91",
pages = "18--23",
journal = "Stereotactic and Functional Neurosurgery",
issn = "1011-6125",
publisher = "S. Karger AG",
number = "1",

}

TY - JOUR

T1 - Thalamotomy as a Treatment Option for Tremor after Ineffective Deep Brain Stimulation

AU - Bahgat, Diaa

AU - Magill, Stephen T.

AU - Berk, Caglar

AU - McCartney, Shirley

AU - Burchiel, Kim

PY - 2013/1

Y1 - 2013/1

N2 - Background: As the number of deep brain stimulation (DBS) surgeries increases, complications from malpositioned electrodes, tolerance to stimulation and loss of efficacy have also increased. Our objective was to assess thalamotomy as a salvage treatment option after ineffective DBS. Methods: A retrospective chart analysis of patients who underwent ipsilateral stereotactic thalamotomy after an ineffective ventrointermediate nucleus DBS procedure was undertaken. Patient outcome was based on follow-up visit chart notes, and a nonvalidated patient telephone questionnaire to assess patients' perception of tremor and functional ability after thalamotomy. Results: Six patients with essential tremor and 1 with tremor-predominant Parkinson's disease met our inclusion criteria. Thalamotomies were undertaken for ineffective DBS due to dysarthria and paresthesias with programming in 2 patients, tremor that failed to respond to increased DBS despite a lack of side effects in 2 patients, malpositioned electrode in 2 patients, and sudden loss of DBS efficacy following eye surgery in 1 patient. Following thalamotomy, 3 patients reported improvement in symptoms and function, 3 patients reported improvement in symptoms that were not reflected in functional improvement, and 1 patient reported no improvement in symptoms or function. Conclusion: Thalamotomy may provide a viable salvage solution in patients who fail to respond to DBS due to complications such as malpositioned electrodes, tolerance to stimulation or loss of efficacy.

AB - Background: As the number of deep brain stimulation (DBS) surgeries increases, complications from malpositioned electrodes, tolerance to stimulation and loss of efficacy have also increased. Our objective was to assess thalamotomy as a salvage treatment option after ineffective DBS. Methods: A retrospective chart analysis of patients who underwent ipsilateral stereotactic thalamotomy after an ineffective ventrointermediate nucleus DBS procedure was undertaken. Patient outcome was based on follow-up visit chart notes, and a nonvalidated patient telephone questionnaire to assess patients' perception of tremor and functional ability after thalamotomy. Results: Six patients with essential tremor and 1 with tremor-predominant Parkinson's disease met our inclusion criteria. Thalamotomies were undertaken for ineffective DBS due to dysarthria and paresthesias with programming in 2 patients, tremor that failed to respond to increased DBS despite a lack of side effects in 2 patients, malpositioned electrode in 2 patients, and sudden loss of DBS efficacy following eye surgery in 1 patient. Following thalamotomy, 3 patients reported improvement in symptoms and function, 3 patients reported improvement in symptoms that were not reflected in functional improvement, and 1 patient reported no improvement in symptoms or function. Conclusion: Thalamotomy may provide a viable salvage solution in patients who fail to respond to DBS due to complications such as malpositioned electrodes, tolerance to stimulation or loss of efficacy.

KW - Deep brain stimulation

KW - Thalamotomy

KW - Tremor

UR - http://www.scopus.com/inward/record.url?scp=84868672332&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84868672332&partnerID=8YFLogxK

U2 - 10.1159/000342491

DO - 10.1159/000342491

M3 - Article

VL - 91

SP - 18

EP - 23

JO - Stereotactic and Functional Neurosurgery

JF - Stereotactic and Functional Neurosurgery

SN - 1011-6125

IS - 1

ER -