Department of Neurosurgery, B and B Hospital, Gwarko, Lalitpur, Nepal.
Department of Surgery, West Hertfordshire Teaching Hospital, United Kingdom.
J Clin Neurosci. 2024 Aug;126:38-45. doi: 10.1016/j.jocn.2024.05.036. Epub 2024 Jun 1.
Essential tremor is a neurological condition associated with movement disorder with more prevalence among adult group of population. The burden of essential tremor is peaking globally but with the advancement in the area of functional neurosurgery such as stereotactic thalamotomy, the quality of life of such patients can be improved drastically.
This systemic review was conducted in accordance to the guidance of preferred Reporting items for Systematic Review and Meta-Analysis(PRISMA). Databases of "PubMed", "Embase", "Web of Science", "Cinhal Plus", and "Scopus" from inception till 2023 was undertaken. A combination of keywords, Medical Subject Headings (MeSH), and search terms such as Search strategy for PubMed search was as follows: "stereotactic thalamotomy" AND "essential tremor".
This systematic review analyzed 9 studies with a total of 274 patients of essential tremor patients. Unilateral thalamotomy was carried out among 268 patients and bilateral thalamotomy in rest of the patients. Vim and Vom nucleus were the site of thalamotmy with ventral intermedius nucleus being the major one. Ten different types of clinical tremor rating scales were used to assess pre operative and post operative improvement in the tremor scales of the individual patients. Dysarthria and limb weakness was noted post operative complication in majority of the cases.
Our study revealed that stereotactic thalamotomy provided good functional outcome in patients of essential tremor who underwent unilateral thalamotomy compared to bilateral thalamotomy. The positive outcome outweighs the complications in such functional surgery.
特发性震颤是一种与运动障碍相关的神经系统疾病，在成年人群中更为普遍。特发性震颤的负担在全球范围内达到高峰，但随着立体定向丘脑切开术等功能神经外科领域的进步，此类患者的生活质量可以得到显著改善。
本系统评价按照系统评价和荟萃分析的首选报告项目（PRISMA）的指导进行。从成立到 2023 年，我们对“PubMed”、“Embase”、“Web of Science”、“Cinhal Plus”和“Scopus”数据库进行了检索。使用了关键词、医学主题词（MeSH）以及如下搜索策略的搜索词的组合：“立体定向丘脑切开术”和“特发性震颤”。
本系统评价分析了 9 项研究，共纳入了 274 例特发性震颤患者。268 例患者接受了单侧丘脑切开术，其余患者接受了双侧丘脑切开术。丘脑切开术的靶点是 Vim 和 Vom 核，其中腹侧中间核是主要靶点。10 种不同类型的临床震颤评分量表用于评估个体患者术前和术后震颤评分的改善情况。大多数情况下，术后会出现构音障碍和肢体无力等并发症。
我们的研究表明，与双侧丘脑切开术相比，单侧丘脑切开术可使特发性震颤患者获得良好的功能结果。这种功能性手术的积极结果超过了并发症。
