Next Thalamic Implants in Patients with Refractory Tremor Tremors can be quite debilitating for many patients with Parkinson's disease, essential tremor or multiple sclerosis.
Medical therapy has some benefit, but the response can be variable or of limited duration.
For patients with incapacitating tremor that is refractory to drug therapy, thalamotomy is effective for 73 to 93 percent of patients, but it carries a complication rate of 9 to 23 percent in patients with Parkinson's disease or essential tremor, and a complication rate of 16 to 41 percent in patients with multiple sclerosis. Bilateral thalamotomy has an even higher complication rate and is no longer performed. A newer alternative to ablative surgery is the use of deep-brain stimulation with an implantable electrode in the thalamus. Several studies have found this procedure to be effective and to have fewer complications than thalamotomy. Schuurman and colleagues conducted a randomized study to compare thalamic stimulation and thalamotomy in patients with refractory unilateral or bilateral tremor from Parkinson's disease, essential tremor or multiple sclerosis.