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Benjamin H Kann, James B Yu, John M Stahl, James E Bond, Christopher Loiselle, Veronica L Chiang, Ranjit S Bindra, Jason L Gerrard, David J Carlson
OBJECTIVE Functional Gamma Knife radiosurgery (GKRS) procedures have been increasingly used for treating patients with tremor, trigeminal neuralgia (TN), and refractory obsessive-compulsive disorder. Although its rates of toxicity are low, GKRS has been associated with some, if low, risks for serious sequelae, including hemiparesis and even death. Anecdotal reports have suggested that even with a standardized prescription dose, rates of functional GKRS toxicity increase after replacement of an old cobalt-60 source with a new source...
December 2016: Journal of Neurosurgery
João Gabriel Ribeiro Gomes, Alessandra Augusta Gorgulho, Amanda de Oliveira López, Crystian Wilian Chagas Saraiva, Lucas Petri Damiani, Anderson Martins Pássaro, João Victor Salvajoli, Ludmila de Oliveira Siqueira, Bernardo Peres Salvajoli, Antônio Afonso Ferreira De Salles
OBJECTIVE The role of tractography in Gamma Knife thalamotomy (GK-T) planning is still unclear. Pyramidal tractography might reduce the risk of radiation injury to the pyramidal tract and reduce motor complications. METHODS In this study, the ventralis intermedius nucleus (VIM) targets of 20 patients were bilaterally defined using Iplannet Stereotaxy Software, according to the anterior commissure-posterior commissure (AC-PC) line and considering the localization of the pyramidal tract. The 40 targets and tractography were transferred as objects to the GammaPlan Treatment Planning System (GP-TPS)...
December 2016: Journal of Neurosurgery
Günther Deuschl
Hyperkinetic movement disorders such as tremors are not uncommon in patients with multiple sclerosis (MS). The classical feature is intention tremor, whereas rest tremors appear not to occur. Treatment is mainly invasive, with options of Gamma Knife surgery, thalamotomy or deep brain stimulation depending on individual circumstances. Deep brain stimulation is the only option for patients who require a bilateral intervention. All treatment recommendations have only low evidence. Tremors can also be cured spontaneously by a subsequent strategic MS lesion...
December 2016: Neurodegenerative Disease Management
Mohammed Alqwaifly
Holmes tremor is a rare symptomatic movement disorder, characterized by a combination of resting, postural, and action tremors. It is usually caused by lesions involving the brainstem, thalamus, and cerebellum. It is often difficult to treat, many medications have been used with varying degrees of success. It may respond to stereotactic thalamotomy and deep brain stimulation in ventralis intermedius nucleus. Here I report a case of Holmes tremor secondary to multiple sclerosis that treated with L-dopa/carpidopa and showed marked improvement...
October 2016: International Journal of Health Sciences
Changwon Jang, Hae-Jeong Park, Won Seok Chang, Chongwon Pae, Jin Woo Chang
Thalamotomy at the ventralis intermedius nucleus has been an effective treatment method for essential tremor, but how the brain network changes immediately responding to this deliberate lesion and then reorganizes afterwards are not clear. Taking advantage of a non-cranium-opening MRI-guided focused ultrasound ablation technique, we investigated functional network changes due to a focal lesion. To classify the diverse time courses of those network changes with respect to symptom-related long-lasting treatment effects and symptom-unrelated transient effects, we applied graph-theoretic analyses to longitudinal resting-state functional magnetic resonance imaging data before and 1 day, 7 days, and 3 months after thalamotomy with essential tremor...
2016: Frontiers in Neurology
Andreas Horn, Laura Kipp, Antonio Meola, Andrea A Kühn, Christoph Leithner
No abstract text is available yet for this article.
October 25, 2016: Neurology
Guozhen Luo, Joseph S Neimat, Anthony Cmelak, Austin N Kirschner, Albert Attia, Manuel Morales-Paliza, George X Ding
PURPOSE: To report on radiosurgery delivery positioning accuracy in the treatment of tremor patients with frameless image guided radiosurgery using the linear accelerator (LINAC) based ExacTrac system and to describe quality assurance (QA) procedures used. METHODS AND MATERIALS: Between 2010 and 2015, 20 patients underwent radiosurgical thalamotomy targeting the ventral intermediate nucleus for the treatment of severe tremor. The median prescription dose was 140 Gy (range, 120-145 Gy) in a single fraction...
August 20, 2016: Practical Radiation Oncology
B H Kann, J B Yu, J Bond, C Loiselle, V L Chiang, R S Bindra, J L Gerrard, D J Carlson
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
T Witjas, R Carron, E Boutin, A Eusebio, J P Azulay, J Régis
Tremor is a highly prevalent movement disorder that markedly reduces quality of life. The management of severe tremor is particularly challenging. Pharmacological treatment is available, but no real breakthrough has emerged recently. Propranolol and primidone are still the two most recommended agents, followed by topiramate. However, surgical treatments for medically refractory tremors are expanding. Gamma knife (GK) thalamotomy is an option particularly suitable for patients who are not candidates for deep brain stimulation...
August 2016: Revue Neurologique
W Jeffrey Elias, Nir Lipsman, William G Ondo, Pejman Ghanouni, Young G Kim, Wonhee Lee, Michael Schwartz, Kullervo Hynynen, Andres M Lozano, Binit B Shah, Diane Huss, Robert F Dallapiazza, Ryder Gwinn, Jennifer Witt, Susie Ro, Howard M Eisenberg, Paul S Fishman, Dheeraj Gandhi, Casey H Halpern, Rosalind Chuang, Kim Butts Pauly, Travis S Tierney, Michael T Hayes, G Rees Cosgrove, Toshio Yamaguchi, Keiichi Abe, Takaomi Taira, Jin W Chang
BACKGROUND: Uncontrolled pilot studies have suggested the efficacy of focused ultrasound thalamotomy with magnetic resonance imaging (MRI) guidance for the treatment of essential tremor. METHODS: We enrolled patients with moderate-to-severe essential tremor that had not responded to at least two trials of medical therapy and randomly assigned them in a 3:1 ratio to undergo unilateral focused ultrasound thalamotomy or a sham procedure. The Clinical Rating Scale for Tremor and the Quality of Life in Essential Tremor Questionnaire were administered at baseline and at 1, 3, 6, and 12 months...
August 25, 2016: New England Journal of Medicine
Alfonso Fasano, Francesco Sammartino, Maheleth Llinas, Andres M Lozano
No abstract text is available yet for this article.
August 16, 2016: Neurology
Shiro Horisawa, Shinichi Goto, Takeshi Nakajima, Taku Ochiai, Takakazu Kawamata, Takaomi Taira
BACKGROUND: Hairdresser's dystonia is a rarely reported form of focal hand dystonia, and the clinical course and treatment remains poorly understood. OBJECTIVES: The aim of this report was to clarify the impact of thalamotomy on hairdresser's dystonia. METHODS: Four consecutive patients with hairdresser's task-specific dystonia evaluated at Tokyo Women's Medical University Hospital between 2008 and 2013 were treated with stereotactic thalamotomy, and were recruited for this case series...
July 20, 2016: Stereotactic and Functional Neurosurgery
Aaron E Bond, Robert Dallapiazza, Diane Huss, Amy L Warren, Scott Sperling, Ryder Gwinn, Binit B Shah, W Jeffrey Elias
INTRODUCTION: Traditional stereotactic radiofrequency thalamotomy has been used with success in medication-refractory tremor-dominant Parkinson disease (PD). Recently, transcranial magnetic resonance-guided focused ultrasound (MRgFUS) has been used to successfully perform thalamotomy for essential tremor. We designed a double-blinded, randomized controlled trial to investigate the effectiveness of MRgFUS thalamotomy in tremor-dominant PD. METHODS: Patients with medication-refractory, tremor-dominant PD were enrolled in the 2-center study and randomly assigned 1:2 to receive either a sham procedure or treatment...
August 2016: Neurosurgery
Gertrúd Tamás, Norbert Kovács, Noémi Ágnes Varga, Péter Barsi, Loránd Erőss, Mária Judit Molnár, István Balás
We present the case of a 66-year-old man who has been treated for essential tremor since the age of 58. He developed mild cerebellar gait ataxia seven years after tremor onset. Moderate, global brain atrophy was identified on MRI scans. At the age of 68, only temporary tremor relief could be achieved by bilateral deep brain stimulation of the ventral intermedius nucleus of the thalamus. Bilateral stimulation of the subthalamic nucleus also resulted only in transient improvement. In the meantime, progressive gait ataxia and tetraataxia developed accompanied by other cerebellar symptoms, such as nystagmus and scanning speech...
July 2016: Neurologia i Neurochirurgia Polska
Zhi Wen, Jie Zhang, Jielan Li, Jiankun Dai, Fuchun Lin, Guangyao Wu
BACKGROUND: Ventral intermediate nucleus thalamotomy is an effective treatment for Parkinson's disease tremor. However, its mechanism is still unclear. PURPOSE: We used resting-state fMRI to investigate short-term ReHo changes after unilateral thalamotomy in tremor-dominant PD, and to speculate about its possible mechanism on tremor suppression. METHODS: 26 patients and 31 healthy subjects (HS) were recruited. Patients were divided into two groups according to right- (rPD) and left-side (lPD) thalamotomy...
2016: PloS One
A R Sitnikov, Yu A Grigoryan, L P Mishnyakova
BACKGROUND: Identification of the crucial role of the anterior thalamic nuclei (ATN) in the generalization of seizures led to increased interest in surgical interventions in this particular area in intractable epilepsy patients. Simulation of ATN destruction in animals demonstrated its high efficacy for both preventing the seizure development and reducing the seizure rate. However, bilateral radiofrequency destruction of the anterior thalamic nuclei in humans has not yet bee described...
2016: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Jörg Wellmer, Jürgen Voges, Yaroslav Parpaley
Lesion guided radiofrequency thermocoagulation (L-RFTC) via stereotactically inserted coagulation probes is a further development of stereotactic thermocoagulation thalamotomy and stereo-EEG guided RFTC. In this method epileptogenic lesions detected via magnetic resonance imaging (MRI) move to the center of coagulation planning. Two surgical strategies can be applied: lesion disconnection and lesion destruction. This focused review collects all data published until January 2016 on L-RFTC for the indications hypothalamic hamartoma, periventricular nodular heterotopia and focal cortical dysplasia and describes technical issues, surgical objectives and outcomes...
October 2016: Seizure: the Journal of the British Epilepsy Association
Shiro Horisawa, Shinichi Goto, Takeshi Nakajima, Takakazu Kawamata, Takaomi Taira
BACKGROUND: Focal hand dystonia in musicians, also known as musician's dystonia, is a task-specific movement disorder characterized by unwanted involuntary muscle contractions occurring only when playing a musical instrument. CASE DESCRIPTION: Case 1 was a 50-year-old female professional pianist who underwent staged bilateral ventro-oral (Vo) thalamotomy, with an interval between the first and second surgery of 4 years. The first surgery (right Vo thalamotomy) led to significant improvements in dystonic symptoms without any complications...
August 2016: World Neurosurgery
Shiro Horisawa, Shinichi Goto, Nobuhiko Takeda, Yuki Takano, Takakazu Kawamata, Takaomi Taira
BACKGROUND/AIMS: Although many reports have confirmed the effects of stereotactic thalamotomy for writer's cramp, pallidotomy for writer's cramp is yet to be investigated. METHODS: After a 22-year-old woman with writer's cramp had undergone stereotactic thalamotomy twice, symptomatic relief was only temporary. Because her dystonic symptoms spread around the proximal part of the upper limb, she underwent unilateral pallidotomy 21 months after the second thalamotomy...
2016: Stereotactic and Functional Neurosurgery
Yves Yamgoue, Etienne Pralong, Marc Levivier, Jocelyne Bloch
We report the successful treatment of recurrent facial pain by deep brain stimulation (DBS) of the ventroposteromedial thalamic nucleus (VPM-DBS), 10 years after VPM thalamotomy. A 62-year-old woman who suffered from an atypical right-sided trigeminal neuralgia of the V1 and V2 branches was successfully treated a decade ago with a radiofrequency VPM thermocoagulation. Ten years later, the same burning right-sided trigeminal pain progressively recurred and was resistant to medical treatments. A DBS procedure was proposed to the patient aiming to stimulate the vicinity of the preexisting stereotactic lesion...
2016: Stereotactic and Functional Neurosurgery
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