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56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

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Deep brain stimulation as treatment of essential tremor

Tiefenhirnstimulation in der Behandlung des essentiellen Tremor

Meeting Abstract

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  • corresponding author R. U. Stiller - Department of Neurosurgery, University Medical Center of Schleswig-Hostein, Campus Kiel
  • M. O. Pinsker - Department of Neurosurgery, University Medical Center of Schleswig-Hostein, Campus Kiel
  • J. Herzog - Department of Neurology, University Medical Center of Schleswig-Hostein, Campus Kiel
  • J. Volkmann - Department of Neurology, University Medical Center of Schleswig-Hostein, Campus Kiel
  • H. M. Mehdorn - Department of Neurosurgery, University Medical Center of Schleswig-Hostein, Campus Kiel

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc11.05.-10.09

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2005/05dgnc0223.shtml

Published: May 4, 2005

© 2005 Stiller et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective

Deep brain stimulation (DBS) is well established as treatment in movement disorders, especially in Parkinson's disease. In our department 208 patients have been treated with DBS during the last 6 years for different indications. With the following data we report on our experience with DBS of the Nucleus ventralis intermedius (VIM) for patients with essential tremor (ET).

Methods

Between 2000 and 2004 16 patients with ET (8 male, 8 female) underwent implantation of DBS electrodes into the VIM. Before implantation of the permanent electrode intraoperative microelectrode recording and macrostimulation was performed in all cases.

Results

Implantation was bilateral in all 16 patients. According to results of intraoperative microelectrode recordings and macrostimulation 17 permanent electrodes were implanted in the central trajectory, followed by 9 in the medial and 9 in anterior trajectory, whereas only 4 were placed in the lateral or posterior trajectory. In 11 patients implantation was not symmetric. Patients were followed up with Fahn and Bain Tremor score. The averaged preoperative score was 58 (Fahn) and 57 (Bain), declined to 31 and 33 at 3-months, at 12-months control 30 and 38 were measured. Best stimulation effect was seen on the lowest contact both sides, for 5 electrodes the stimulated contact was transferred into contact 1 or 2 because of ataxia or dysaesthesia under stimulation (9 patients).

Conclusions

In ET bilateral VIM stimulation significantly reduces handicap caused by both extremity and head and neck tremor. As most effective stimulation site the centro- and medio-caudal portion of VIM was localised. After 1 year of stimulation the effect was not fading as far as our follow-up could show.