Department of Neurology, Louisiana State University, Shreveport, Louisiana, USA.
Department of Radiology, Willis Knighton Health System, Shreveport, Louisiana, USA.
Mov Disord. 2019 Jan;34(1):124-129. doi: 10.1002/mds.27545. Epub 2018 Nov 19.
Medically intractable tremors are a common, difficult clinical situation. Deep brain stimulation decreases Parkinson's disease resting tremor and essential tremor, but not all patients are candidates from a diagnostic, medical, or social standpoint, prompting the need for alternative surgical strategies.
We describe 13 patients with medically intractable tremor treated with laser interstitial thermal thalamotomy performed under general anesthesia using live MRI-guidance and the Clearpoint stereotactic system.
All patients had a dramatic decrease in tremor immediately postoperatively, which has been sustained through follow-up (3-17 months) in all but 1 patient (mean tremor score reduction of 62%; 10.33 ± 2.69 to 3.89 ± 3.1). Objective side effects were transient and included imbalance and paresthesia.
Medically intractable tremor treated with laser interstitial thermal thalamotomy may be a useful addition to the treatment armamentarium for medically intractable tremor disorders. © 2018 International Parkinson and Movement Disorder Society.
医学上难以治疗的震颤是一种常见且棘手的临床情况。深部脑刺激可降低帕金森病静止性震颤和原发性震颤，但从诊断、医学或社会角度来看，并非所有患者都适合，这促使人们需要寻求替代的手术策略。
我们描述了 13 例采用激光间质热丘脑切开术治疗的医学上难以治疗的震颤患者，该手术在全身麻醉下使用实时 MRI 引导和 ClearPoint 立体定向系统进行。
所有患者术后即刻震颤明显减轻，除 1 例患者（平均震颤评分降低 62%，从 10.33±2.69 降至 3.89±3.1）外，所有患者在随访期间（3-17 个月）均保持这种状态。客观副作用是短暂的，包括平衡障碍和感觉异常。
采用激光间质热丘脑切开术治疗医学上难以治疗的震颤可能是治疗医学上难以治疗的震颤障碍的有效手段。 © 2018 国际帕金森病和运动障碍学会。
