• World Neurosurg · Nov 2012

    Case Reports

    Reoperation after failed deep brain stimulation for essential tremor.

    • Patric Blomstedt, Peter Lindvall, Jan Linder, Magnus Olivecrona, Lars Forsgren, and Marwan I Hariz.
    • Department of Pharmacology and Clinical Neuroscience, Section of Neurosurgery, Umeå University, Umeå, Sweden. patric.blomstedt@neuro.umu.se
    • World Neurosurg. 2012 Nov 1;78(5):554.e1-5.

    ObjectiveTo evaluate the effects of reoperation with deep brain stimulation (DBS) in the caudal zona incerta (cZi) in patients with failed DBS in the ventral intermediate (Vim) nucleus of the thalamus for essential tremor.MethodsThe results of reoperation with cZi DBS in five patients with failed Vim DBS were retrospectively analyzed.ResultsTwo patients had early failure of Vim DBS, and three after several years of good effect. The mean deviation from the atlas Vim target point was 1.4 mm. Before the reoperation Vim DBS improved hand function and tremor in the treated hand at 25 %, whereas cZi DBS achieved an improvement of 57%. Although cZi was more efficient than Vim DBS, also in the patients with late failure of Vim DBS, they still exhibited a considerable residual tremor on cZi DBS.ConclusionsThe effect on tremor was, in this small sample population, improved by implanting an electrode in the cZi. The effect was modest in those patients suffering a deterioration years after the initial operation.Copyright © 2012 Elsevier Inc. All rights reserved.

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