Patient description: A 22-year-old Caucasian man came to the Clinic with a history of tremors since a year ago. The tremor was first in his right hand while holding something. Later the tremor became continuous and extended to both hands and legs and even at rest. The Kayser-Fleischer' ring was detected in the ophthalmologic exam. The physical exam revealed jaundice, hepatosplenomegaly and hypotonia of the upper limbs. He had a constant smile on his face, however, he has aggressive behavior according to his parents' explanation. His laboratory study was significant for a low serum caeruloplasmin (0.05 g/l), and a raised 24 hour urine copper excretion (120 μg/24 h). Wilson disease was confirmed by high liver copper concentration (305 μg/g dry weight of liver).

Clinical trial eligibility criteria: eligible ages (years): 21.0-99.0,  Essential Tremor Patient gives an informed consent Patient is over 21 years of age Patient is diagnosed with a postural-intention (essential) tremor for at least 3 years, meets diagnostic for ET, has been evaluated and examined by a movement disorders fellowship trained neurologist, and is being treated with traditional VIM DBS therapy Patient has no evidence of non-ET central nervous system disease or injury and has had a significantly disabling, upper extremity tremor despite ongoing VIM DBS therapy for at least three (3) months prior to DBS revision surgery Patient has a postural or kinetic tremor severity score of at least 2 out of 4 in the extremity intended for treatment on the Fahn-Tolosa-Marin Clinical Rating Scale for Tremor (TRS) despite ongoing VIM DBS therapy Patient has a TRS score of 2 or above in any one of the items 16-23 from the Disability subsection of the TRS: speaking, feeding other than liquids, bringing liquids to mouth, hygiene, dressing, writing, working and social activities despite ongoing VIM DBS therapy Patient's tremor is refractory to adequate trials of at least two medications, one of which should be either propranolol or primidone. Proof of this is not required for patients with a current device that is being removed and replaced with a new device. An adequate medication trial is defined as a therapeutic dose of each medication or the development of side effects as the medication dose is titrated Patient is available for appropriate follow-up times for the length of the study  Any previous neurosurgical intervention other than VIM DBS, including ablative brain lesions for tremor suppression Medication related movement disorders Any suspicion of Parkinson's disease, including presence of Parkinsonian features such as bradykinesia, rigidity, or postural instability Any behaviors consistent with alcohol or substance abuse as defined by the outlined in Diagnostic and Statistical Manual of Mental Disorders (DSM-V) Severe medical co-morbidity including cardiovascular disorder, lung disorder, kidney disease, continuous neurological disease, hematological disease, or frailty that impact tolerability of the surgery as judged by the screening physicians Abnormal brain MRI including hydrocephalus, stroke, structural lesions, demyelinating lesions, or infectious lesions. Also excluded will be subjects with severe brain atrophy Any uncontrolled symptoms or signs of increased intracranial pressure (e.g., headache, nausea, vomiting, lethargy, papilledema) A history of seizures within the past year A dementia rating scale score (DRS) <130 signifying significant cognitive dysfunction and a potential for inability to cooperate with tasks involved in the study Any attempt or intent of suicide during the previous six months