What Should be the Anatomical Target in Deep Brain Stimulatıon in an Essential Tremor Plus Rest Tremor Case? Technical Case Report of Deep Brain Stimulation
Abstract
While Deep Brain Stimulation (DBS) of Subthalamic Nucleus (STN) is effective on resting tremors, but its effectiveness on postural and kinetic tremors is limited. DBS of the Ventral Intermediate Nucleus (VIM) is effective on many types of tremors, especially postural and kinetic tremors, but its effect is weak on motor symptoms in Parkinson’s disease (PD). Although there is a consensus in the literature about where the anatomical target should be in essential tremor (ET) and PD, there are only case reports about where the anatomical target should be in Essential Tremor Plus Rest Tremor (ET+RT) cases.In this article, we aimed to reveal the effectiveness of STN DBS in a case-diagnosed with ET+RT. The patient had action tremors in both upper extremities for 21 years and developed rest tremors in both upper and lower extremities for the last six years. Rest tremor was effectively controlled with bilateral STN DBS. Postural tremor in the right upper extremity was continued, although it decreased.STN may be an appropriate choice when choosing an anatomical target in DBS in cases of resting, postural, and kinetic tremor.
Keywords
Essential tremor plus rest tremor, deep brain stimulation, subtalamic nucleus
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