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  • Title: [Continuous electric thalamus stimulation for the treatment of tremor resistant to pharmacotherapy].
    Author: Speelman JD, Bosch DA.
    Journal: Ned Tijdschr Geneeskd; 1995 May 06; 139(18):926-30. PubMed ID: 7753224.
    Abstract:
    OBJECTIVE: To determine the efficacy of continuous electrical thalamic stimulation in the treatment of pharmacotherapy-resistant tremor in patients with Parkinson's disease and essential tremor. DESIGN: Descriptive study. SETTING: Academic Medical Centre, Academic Hospital of the University of Amsterdam. METHOD: Five patients with Parkinson's disease and one with familial essential tremor suffering from pharmacotherapy-resistant tremor were treated by implantation of a four-polar stimulation electrode in the contralateral ventrolateral thalamic nucleus connected subcutaneously to a stimulator. Continuous electrical stimulation was applied in the daytime and switched off during the night. Three of the Parkinson patients were subjected to contralateral thalamotomy as well. RESULTS: Three patients (including the one with essential tremor) had complete tremor suppression during stimulation, and the other three had intermittent minimal tremor. There were no early complications (follow-up: 1 month-1 year). One patient had mild hemi-inattention and pyramidal signs due to the thalamotomy. CONCLUSION: Continuous thalamic stimulation appears to be a good alternative to thalamotomy. It renders possible bilateral surgical treatment for severe bilateral tremor.
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