Thalamotomy for essential tremor : a very long-term follow-up

Background: DBS (deep brain stimulation) is currently the golden standard in the surgical treatment of ET (essential tremor). Despite the benefits of DBS, there remain situations where lesional surgery may provide an alternative. Objective: To perform a very long-term retrospective evaluation of thalamotomies for ET. Methods: Nine patients who underwent thalamotomy for ET during 1972–1999 (follow-up period 20.8 ± 5.2 years) were assessed with regard to tremor scores, side effects, and quality of life, as well as lesion size and location. Results: All patients had tremor recurrence, although hand function remained slightly better on the treated side than on the non-treated side. Side effects that could be attributed to the procedure were frequent and did in some cases result in a disability for the patient. Quality of life was poorer in this group than in an age-adjusted healthy population. No correlation between lesion size, location, and long-term outcome could be established. Conclusions: In this study population the benefits of thalamotomies were limited, while complications were frequent.Originally published in thesis in manuscript form.