Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Comparison of Thalamotomy with Deep Brain Stimulation in Essential Tremor

본태성 진전에 대한 시상파괴술과 뇌심부 자극술의 비교

  • Lee, Yoon-Ho (Department of Neurosurgery, Yonsei University College of Medicine) ;
  • Park, Yong-Sook (Department of Neurosurgery, Yonsei University College of Medicine) ;
  • Chang, Jong-Hee (Department of Neurosurgery, Yonsei University College of Medicine) ;
  • Chang, Jin-Woo (Department of Neurosurgery, Yonsei University College of Medicine) ;
  • Park, Yong-Gou (Department of Neurosurgery, Yonsei University College of Medicine) ;
  • Chung, Sang-Sup (Department of Neurosurgery, Yonsei University College of Medicine)
  • 이윤호 (연세대학교 의과대학 신경외과학교실) ;
  • 박용숙 (연세대학교 의과대학 신경외과학교실) ;
  • 장종희 (연세대학교 의과대학 신경외과학교실) ;
  • 장진우 (연세대학교 의과대학 신경외과학교실) ;
  • 박용구 (연세대학교 의과대학 신경외과학교실) ;
  • 정상섭 (연세대학교 의과대학 신경외과학교실)
  • Published : 2005.02.28
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Abstract

Objective: Thalamic lesioning and deep brain stimulation(DBS) have proved to be beneficial to the treatment of essential tremor(ET). The authors compared the effects and complications of two modalities. Methods: A total of 34 patients with ET were treated with ventral intermediate(Vim) nucleus thalamotomy or Vim DBS from May 1999 to May 2003. The procedure of lesioning or stimulation were performed as usual manner with or without microelectrode recording. Postoperatively, utilizing the various combinations of frequency, voltage and pulse width optimized the stimulation. The degree of improvements of tremor and the occurrence of the complications were evaluated postoperatively and at follow-up. Results: There were 38 procedures, including 27 with Vim thalamotomy and 11 with DBS, in 34 patients. Of the thalamotomy group, left Vim lesioning is 25 and right one is 2. Follow-up duration ranged from 12 to 57 months. In the thalamotomy group, the rate of overall good outcome was 88.9% but 12 patients (44.4%) showed permanent adverse effects. In the cases of stimulation, the rate of overall good outcome was 90.9% and two patients had acceptable dysarthria. Conclusion: Both Vim thalamotomy and Vim DBS were effective for the treatment of ET, although perioperative adverse effects tended to be higher in patients who had thalamotomy. In cases of DBS, adjustments of stimulation parameters enabled an acceptable position to be achieved with tremor control and unwanted effects.

Keywords

References

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