Successful subthalamic stimulation after failed gamma-knife thalamotomy in the treatment of tremor-dominant Parkinson’s disease

Sobstyl, Michał; Konopka, Marcin; Aleksandrowicz, Marta; Pasterski, Tomasz; Ząbek, Mirosław

doi:10.5603/pjnns.a2018.0007

Cited by 3 publications

(4 citation statements)

References 5 publications

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“…But these complications rapidly resolved during post-operative period 18 . Similarly, in a study conducted by Sobstyl et al in 41 tremor predominant Parkinsonian patients who underwent stereotactic VIM Thalamotomy, 13 patients had transient and 6 had permanent complications 7 . In a case series of 89 Subthalamotomy conducted by Alvarez et al, 52 patients developed contralateral dyskinesia that resolved gradually in 38 cases.…”

Section: Discussionmentioning

confidence: 80%

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Comparison of Stereotactic Subthalamotomy and Ventralis Intermedius (VIM) Thalamotomy in Relieving Parkinsonian Tremor

Lamichhane

Mahmood

2020

Pak J Neurol Surg

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Background/Objectives: Parkinson’s disease is a neurodegenerative disease with cardinal features of tremor, rigidity, postural instability and bradykinesia. Surgery is indicated for the patients not responding to medical management or who develop motor fluctuations and dyskinesia following prolonged levodopa therapy. Stereotactic Subthalamotomy and VIM (Ventralis Intermedius) Thalamotomy is cheap, safe and effective surgical options for the treatment of Parkinsonian tremor. The objective of the study was to compare Stereotactic Subthalamotomy with Ventralis Intermedius (VIM) Thalamotomy, in terms of improvement in Unified Parkinson’s Disease Rating Scale (UPDRS), for the treatment of Parkinsonian tremor. Material and Methods: This is a randomized control trial (RCT) and 38 tremor predominant Parkinsonian patients were enrolled in the study. Half of the patients underwent Stereotactic Subthalamotomy and another half underwent VIM Thalamotomy. Patients were assessed pre-operatively, immediately post-operatively and followed up at three weeks, six weeks and three months by using UPDRS scores. Results: The mean age of patients was 59.58 years and they were predominantly male. Post-operative UPDRS score was improved significantly in both STN and VIM groups. However, the improvement was significantly higher in STN lesioning compared to VIM lesioning.On the other hand, the improvement in tremor component score of UPDRS was comparable in the both groups. Moreover, post-operative complications were higher following Subthalamotomy (21.05%) which included dyskinesia, dysphasia, transient weakness and hematoma formation. Conclusion: Both Stereotactic Subthalamotomy and VIM Thalamotomy are equally effective in relieving Parkinsonian tremor with a lower complication rate following VIM Thalamotomy.

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Section: Discussionmentioning

confidence: 80%

“…Final level of accuracy lies in functional mapping using pre-operative macro-electrode stimulation in awake before making permanent lesion using radiofrequency lesion generator. 7…”

Section: Introductionmentioning

confidence: 99%

Comparison of Stereotactic Subthalamotomy and Ventralis Intermedius (VIM) Thalamotomy in Relieving Parkinsonian Tremor

Lamichhane

Mahmood

2020

Pak J Neurol Surg

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“…Although concerns remain that previous lesioning procedure could limit the effectiveness of future DBS, previous studies have shown that DBS can be successfully performed following RF, gamma-knife and FUS thalamotomy [6][7][8][9][10].…”

Section: B Amentioning

confidence: 99%

“…In addition, since changes in nerve fibers related to tremor cannot be predicted when permanent lesioning is performed in the thalamus, it is difficult to determine whether DBS targeting the vicinity of the preexisting stereotactic lesion is effective. There have been several reports of DBS being successfully performed in the area close to the previous lesion, but there is no guarantee that it can be applied to all cases, particularly when the intraoperative findings are different from the expected [7][8][9][10].…”

Section: B Amentioning

confidence: 99%

Posterior subthalamic area deep brain stimulation for recurrent tremor after ventral intermediate nucleus thalamotomy: a case report

Lee

Jung

2022

J Korean Ster Func Neurosurg

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Neurosurgical treatments, including both lesioning procedures and deep brain stimulation (DBS), are considered effective treatments for patients with intractable essential tremor (ET). However, it can be challenging to arrive at the decision to perform a second surgical attempt for recurrent ET after the initial neurosurgical treatment because of the uncertainty of successful results. We encountered a 49-year-old man who complained of recurrent tremor after ventral intermediate nucleus thalamotomy. The patient underwent DBS in the posterior subthalamic area (PSA), resulting in significantly reduced tremor and improved daily function. Although there are various surgical options for recurrent ET, DBS targeting the PSA induces favorable tremor control and can be successfully used as a salvage therapy after thalamotomy.

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Levodopa/rasagiline/trihexyphenidyl

2019

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Successful subthalamic stimulation after failed gamma-knife thalamotomy in the treatment of tremor-dominant Parkinson’s disease

Cited by 3 publications

References 5 publications

Comparison of Stereotactic Subthalamotomy and Ventralis Intermedius (VIM) Thalamotomy in Relieving Parkinsonian Tremor

Comparison of Stereotactic Subthalamotomy and Ventralis Intermedius (VIM) Thalamotomy in Relieving Parkinsonian Tremor

Posterior subthalamic area deep brain stimulation for recurrent tremor after ventral intermediate nucleus thalamotomy: a case report

Levodopa/rasagiline/trihexyphenidyl

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