Gamma knife radiosurgery for essential tremor: A Case report and review of the literature

Alexander R Mackay,Wayne T Lamoreaux,Barton S Cooke,John J Demakas,David R Greeley,Robert K Fairbanks,Benjamin J Arthurs,Christopher M Lee,Ameer L Elaimy

doi:10.1186/1477-7819-8-20

Abstract

Approximately 5 million people in America are affected by essential tremors (ET), which are classified as a type of benign movement disorder. This disease manifests as tremors that usually occur in the hands, but they may also be present in the head, face, tongue, and lower limbs. Radiofrequency thalamotomy (RF) and deep brain stimulation (DBS) are common invasive procedures with proven track records that are used to treat ET. Although these procedures have high success rates, they still put patients at risk of potential side effects and are invasive by nature. Thalamotomy using the gamma knife (GK) also produces favorable outcomes in treating tremors, without the complications associated with invasive neurosurgery procedures. This report describes the presenting symptoms and extended treatment outcome for a patient with an advanced case of ET, who received GK thalamotomy treatment six years ago. Because of this non-invasive treatment, she regained the ability to paint and live with an improved quality of life. We also discuss and review the relevant literature regarding the risks and benefits of this treatment modality. GK thalamotomy is one effective option for the treatment of ET, and due to its noninvasive nature, it has a different risk profile than neurosurgery. We suggest that GK thalamotomy should be presented as one viable treatment option to all ET patients, and should be recommended to those who would be best served by less invasive treatment techniques.

Highlights

Essential tremor is a common type of movement disorder that normally affects people over the age of 65; this illness can occur in younger patients as well
gamma knife (GK) thalamotomy is a safe alternative to invasive neurosurgery, and evidence shows it is successful in the treatment of essential tremors (ET) and similar movement disorders [5,7,8,9,10,11]
We present an inspiring case of an ET patient, whose daily life was drastically modified by the severity of her hand tremors, until GK thalamotomy treatment restored her ability to control movement and pursue her passion of painting

Summary

Introduction

Essential tremor is a common type of movement disorder that normally affects people over the age of 65; this illness can occur in younger patients as well. Even though surgical treatments such as RF thalamotomy and DBS are effective in many patients with ET, there are those who are not qualified candidates for invasive neurosurgery because of comorbid medical conditions. GK thalamotomy is a safe alternative to invasive neurosurgery, and evidence shows it is successful in the treatment of ET and similar movement disorders [5,7,8,9,10,11]. We present an inspiring case of an ET patient, whose daily life was drastically modified by the severity of her hand tremors, until GK thalamotomy treatment restored her ability to control movement and pursue her passion of painting.

Results

Conclusion