Surgical treatments for essential tremor.

Surgical treatments for essential tremor. Expert Rev Neurother. 2018 Feb 23;: Authors: Elble RJ, Shih L, Cozzens JW Abstract INTRODUCTION: Essential tremor is the most common form of pathologic tremor. Surgical therapies disrupt tremorogenic oscillation in the cerebellothalamocortical pathway and are capable of abolishing severe tremor that is refractory to available pharmacotherapies. Surgical methods are rapidly improving and are the subject of this review. Areas covered: A PubMed search on January 18, 2018 using the query essential tremor AND surgery produced 839 abstracts. 379 papers were selected for review of the methods, efficacy, safety and expense of stereotactic deep brain stimulation (DBS), stereotactic radiosurgery (SRS), focused ultrasound (FUS) ablation, and radiofrequency ablation of the cerebellothalamocortical pathway. Expert Commentary: DBS and SRS, FUS and radiofrequency ablations are capable of reducing upper extremity tremor by more than 80% and are far more effective than any available drug. The main research questions at this time are 1) the relative safety, efficacy and expense of DBS, SRS and FUS performed unilaterally and bilaterally, 2) the relative safety and efficacy of thalamic versus subthalamic targeting, 3) the relative safety and efficacy of atlas-based versus direct imaging tractography-based anatomical targeting, and 4) the need for intraoperative microelectrode recordings and macroelectrode stimulation in awake patien...
Source: Expert Review of Neurotherapeutics - Category: Neurology Tags: Expert Rev Neurother Source Type: research