Is Deep Brain Stimulation still an option for tremor recurrence after Focused Ultrasound thalamotomy? A case report

Vincenzo Levi, Roberto Eleopra, Angelo Franzini, L. Romito

Research output: Contribution to journalArticlepeer-review

Abstract

With the development of MRI-guided focused ultrasound (FUS), there is an ongoing renewal of interest for ablative procedures as a surgical option for tremor disorders. One of the main criticisms regarding FUS thalamotomy is the potential recurrence of tremor symptoms during follow-up. In case of tremor reappearance, repeating the ultrasound ablation may represent a reasonable option. However, tremor is often perceived as a highly disabling condition and patients may be reluctant to undergo the same unsuccessful treatment again. In this context, few data are available about the feasibility of Deep Brain Stimulation (DBS) in case of tremor recurrence after FUS. Moreover, concerns exist that FUS lesioning could preclude or limit the effectiveness of future DBS. Here we present the case of a 73-year-old right-handed man with a disabling, right-hand, mixed tremor recurring after initial successful FUS thalamotomy and that was properly managed in the end with thalamic Deep Brain Stimulation. Our case suggests that DBS and FUS thalamotomy are not mutually exclusive, but rather they represent complementary tools in the surgical approach to tremor.

Original languageEnglish
Pages (from-to)344-346
Number of pages3
JournalJournal of Clinical Neuroscience
Volume68
DOIs
Publication statusPublished - Oct 2019

Keywords

  • Deep Brain Stimulation (DBS)
  • Focused Ultrasound (FUS)
  • Recurrence
  • Tremor

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology
  • Physiology (medical)

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