Transcript Treatment of Essential Tremor with Stereotactic

Treatment of Essential Tremor
with Stereotactic Radiosurgery
Presenter: Christopher Loiselle, MD
Poster # 1024
Treatment of Essential Tremor with
Stereotactic Radiosurgery
• Essential tremor
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Very common (5% population > age 65)
Primarily an action tremor
95% of the time affects hands
Can be disabling leading to basic activities such as
writing, drinking, eating, cooking, using utensils,
brushing teeth, holding a tray.
– Familial in 60%
– Pathophysiologic recordings of VIM thalamus
demonstrate neurons that dischage excessively and
synchronously
Treatment of Essential Tremor with
Stereotactic Radiosurgery
• Essential tremor
– Treatment options: medical therapy, deep brain
stimulation, radiosurgical thalamotomy
– Radiosurgical thalamotomy is an ideal treatment for
patients with medically refractory disease who are
not candidates for deep brain stimulation
Treatment of Essential Tremor with
Stereotactic Radiosurgery
• Current retrospective series:
– 99 thalamotomies with the Gamma Knife in 94
patients
– 77% of cases had major improvement in drawing
– 81% of cases had major improvement in writing
– 7 patients developed side effects following treatment
including contralateral numbness, contralateral
weakness, or speech difficulty. One patient’s side
effects resolved during the followup period.
Treatment of Essential Tremor with
Stereotactic Radiosurgery
• For patients with a positive result (about
80%), the benefits of treatment are a
remarkable improvement in life quality
• The future:
– Prospective studies
– Development of patient selection tools and/or
treatment techniques to further minimize potential
side effects.