• World Neurosurg · Jul 2023

    Gamma Knife Thalamotomy for Essential Tremor: A Retrospective Analysis.

    • Shiro Horisawa, Motohiro Hayashi, Noriko Tamura, Kotaro Kohara, Taku Nonaka, Tomoko Hanada, Takakazu Kawamata, and Takaomi Taira.
    • Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan. Electronic address: neurosurgery21@yahoo.co.jp.
    • World Neurosurg. 2023 Jul 1; 175: e90e96e90-e96.

    BackgroundGamma knife (GK) thalamotomy has been used as a treatment option for essential tremor (ET). Numerous studies on GK use in ET treatment have reported more varied responses and complication rates.MethodsData from 27 patients with ET who underwent GK thalamotomy were retrospectively analyzed. The Fahn-Tolosa-Marin Clinical Rating Scale for Tremor, handwriting, and spiral drawing were evaluated. Postoperative adverse events and magnetic resonance imaging findings were also evaluated.ResultsThe mean age at GK thalamotomy was 78.1 ± 4.2 years. The mean follow-up period was 32.5 ± 19.4 months. The preoperative postural tremor, handwriting, and spiral drawing scores were 3.4 ± 0.6, 3.3 ± 1.0, and 3.2 ± 0.8, respectively, all of which showed significant improvements to 1.5 ± 1.2 (55.9% improvement, P < 0.001), 1.4 ± 1.1 (57.6% improvement, P < 0.001), and 1.6 ± 1.3 (50% improvement, P < 0.001), respectively, at the available final follow-up evaluations. Three patients presented with no improvement in tremor. Six patients presented with adverse effects, including complete hemiparesis, foot weakness, dysarthria, dysphagia, lip numbness, and finger numbness, at the final follow-up period. Two patients presented with serious complications, including complete hemiparesis due to massive widespread edema and chronic encapsulated expanding hematoma. One patient died of aspiration pneumonia following severe dysphagia secondary to chronic encapsulated expanding hematoma.ConclusionsGK thalamotomy is an efficient procedure for treating ET. Careful treatment planning is necessary to reduce complication rates. The prediction of radiation complications will increase the safety and effectiveness of GK treatment.Copyright © 2023 Elsevier Inc. All rights reserved.

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