Deep brain stimulation of the ventral intermediate nucleus of the thalamus in medically refractory orthostatic tremor: preliminary observations.

摘要: Orthostatic tremor (OT) is a disabling movement disorder associated with postural and gait impairment in the elderly. Medical therapy often yields insufficient benefit. We report clinical electrophysiological data on two patients medication-refractory OT treated deep brain stimulation of ventral intermediate thalamic nucleus (Vim DBS). Patient 1 underwent bilateral (DBS) 2 unilateral Vim DBS following 28 30 years disease duration, respectively. Both showed increased latency to symptom onset after rising from seated position, improved tolerance for prolonged standing, slower crescendo severity when remaining upright. Postoperative evaluation demonstrated decreased amplitude electromyographic activity persistence well-defined oscillatory behavior showing strong coherence at 15 Hz between all muscles tested upper lower limbs. Postural sway was unchanged. Clinical benefits have been sustained over 18 months 1, receded 3 2. These findings support consideration implantation as therapeutic option medically refractory OT. Further efficacy studies chronic disrupt abnormal this are warranted. © 2008 Movement Disorder Society