Tolerance and tremor rebound following long-term chronic thalamic stimulation for Parkinsonian and essential tremor.

摘要: Fifty-eight patients, 36 with essential tremor (ET) and 22 Parkinson's disease (PD), received deep brain stimulation (DBS) in the thalamic ventral intermediate (Vim) nucleus. The mean follow-up was 17 months for ET 21 PD patients. Stimulation parameters were adjusted as needed, at various intervals after surgery. Results assessed using routine clinical evaluation established outcome scales. All patients needed incremental increase during first 6-12 voltage 1 week postoperatively 1. 45 V 1.37 Twelve later, figures 2.14 2.25 At year, Essential Tremor Rating Scale (ETRS) improved from 54 to 28 (p < 0.0001). motor part of Unified Disease (UPDRS) 37 26 0.01). items UPDRS more markedly One 90% PD, 89% free. year 70% 60% remained mostly Upon switching off stimulation, there a clear tendency rebound = 0.07) group, requiring continuous 24-hour some Permanent non-adjustable ataxia induced by 2