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Outcome of Gamma Knife Thalamotomy in Patients with an Intractable Tremor
Journal of Korean Neurosurgical Society ; : 192-196, 2015.
Article in English | WPRIM | ID: wpr-223801
ABSTRACT

OBJECTIVE:

Tremor is a common movement disorder that interferes with daily living. Since the medication for tremor has some limitations, surgical intervention is needed in many patients. In certain patients who cannot undergo aggressive surgical intervention, Gamma Knife thalamotomy (GKT) is a safe and effective alternative.

METHODS:

From June 2012 to August 2013, 7 patients with an intractable tremor underwent GKT. Four of these 7 patients had medical comorbidities, and 3 patients refused to undergo traditional surgery. Each patient was evaluated with the modified Fahn-Tolosa-Marin tremor rating scale (TRS) along with analysis of handwriting samples. All of the patients underwent GKT with a maximal dose of 130 Gy to the left ventralis intermedius (VIM) nucleus of the thalamus. Follow-up brain MRI was performed after 3 to 8 months of GKT, and evaluation with the TRS was also performed.

RESULTS:

Six patients showed objective improvement in the TRS score. Excluding one patient who demonstrated tremor progression, there was 28.9% improvement in the TRS score. However, five patients showed subjective improvement in their symptoms. On comparing the TRS scores between follow-up periods of more and less than 4 months, the follow-up TRS score at more than 4 months of GKT was significantly improved compared to that at less than 4 months of GKT. Follow-up MRI showed radiosurgical changes in 5 patients.

CONCLUSION:

GKT with a maximal dose of 130 Gy to the VIM is a safe procedure that can replace other surgical procedures.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Thalamus / Tremor / Brain / Magnetic Resonance Imaging / Comorbidity / Follow-Up Studies / Handwriting / Movement Disorders Type of study: Observational study / Prognostic study Limits: Humans Language: English Journal: Journal of Korean Neurosurgical Society Year: 2015 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Thalamus / Tremor / Brain / Magnetic Resonance Imaging / Comorbidity / Follow-Up Studies / Handwriting / Movement Disorders Type of study: Observational study / Prognostic study Limits: Humans Language: English Journal: Journal of Korean Neurosurgical Society Year: 2015 Type: Article