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Long-term follow-up of thalamic deep brain stimulation for essential and parkinsonian tremor

From the Divisions of Neurology (Drs. Kumar and Lang, and E. Sime) and Neurosurgery (Dr. Lozano), Faculty of Medicine, University of Toronto, Canada; and Colorado Neurological Institute (Dr. Kumar), Englewood.

Address correspondence and reprint requests to Dr. Rajeev Kumar, Colorado Neurological Institute, 701 E. Hampden Ave., Suite 530, Englewood, CO 80110-2778; e-mail: rajeev_kumar{at}msn.com

Thirteen consecutive patients with thalamic deep brain stimulation (DBS) were examined serially for 3 to 5 years. Initially, all demonstrated at least 50% improvement in contralateral tremor. At last follow-up, three of eight patients with Parkinson disease no longer used DBS because tremor had markedly improved, and for two, motor fluctuations and levodopa-induced dyskinesias became the major disability, with tremor less troublesome. Two of five patients with essential tremor had contralateral tremor improvement after ongoing stimulation for 2 years; two developed marked tolerance to DBS.

Received May 11, 2001. Accepted in final form August 27, 2003.

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