Feasibility of Staged Bilateral Radiofrequency Ventral Intermediate Nucleus Thalamotomy for Bilateral Essential Tremor.
Bilateral Vim thalamotomy
Bilateral tremor
Radiofrequency lesioning
Journal
World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275
Informations de publication
Date de publication:
05 2019
05 2019
Historique:
received:
22
08
2018
revised:
30
01
2019
accepted:
31
01
2019
pubmed:
17
2
2019
medline:
4
1
2020
entrez:
17
2
2019
Statut:
ppublish
Résumé
Patients with bilateral and/or midline/axial tremor have significant diminution in quality of life (QOL). Various studies report high complication rates with bilateral thalamotomy. However, use of primitive methods in these studies confers questionable validity. We conducted a retrospective observational cohort study in patients with medication-refractory bilateral essential tremor treated with staged bilateral radiofrequency ventral intermediate nucleus thalamotomy to subjectively examine the impact of any adverse effects on QOL and patient satisfaction. Eight patients who had undergone staged bilateral radiofrequency ventral intermediate nucleus thalamotomy were included and completed a customized questionnaire. Patients returned the completed questionnaire by mail for statistical analysis. All 8 patients had improved QOL. Seven patients were satisfied with the received treatment, although residual neck and hand tremor remained in 5 and 4 patients, respectively. None of the patients reported worsening of symptoms or severe disability in any area. Adverse effects included speech difficulty, difficulty in concentration, memory loss, and calculation difficulty. All 8 patients were self-reliant in doing everyday tasks that were not possible before the treatment suggesting the nondisabling nature of the adverse effects that occurred. Adverse effects that are nondisabling and hence acceptable to the patient can be considered acceptable adverse effects. Staged bilateral radiofrequency ventral intermediate nucleus thalamotomy definitely improves QOL in patients with medication-refractory bilateral essential tremor despite occurrence of acceptable adverse effects.
Sections du résumé
BACKGROUND
Patients with bilateral and/or midline/axial tremor have significant diminution in quality of life (QOL). Various studies report high complication rates with bilateral thalamotomy. However, use of primitive methods in these studies confers questionable validity. We conducted a retrospective observational cohort study in patients with medication-refractory bilateral essential tremor treated with staged bilateral radiofrequency ventral intermediate nucleus thalamotomy to subjectively examine the impact of any adverse effects on QOL and patient satisfaction.
METHODS
Eight patients who had undergone staged bilateral radiofrequency ventral intermediate nucleus thalamotomy were included and completed a customized questionnaire. Patients returned the completed questionnaire by mail for statistical analysis.
RESULTS
All 8 patients had improved QOL. Seven patients were satisfied with the received treatment, although residual neck and hand tremor remained in 5 and 4 patients, respectively. None of the patients reported worsening of symptoms or severe disability in any area. Adverse effects included speech difficulty, difficulty in concentration, memory loss, and calculation difficulty. All 8 patients were self-reliant in doing everyday tasks that were not possible before the treatment suggesting the nondisabling nature of the adverse effects that occurred.
CONCLUSIONS
Adverse effects that are nondisabling and hence acceptable to the patient can be considered acceptable adverse effects. Staged bilateral radiofrequency ventral intermediate nucleus thalamotomy definitely improves QOL in patients with medication-refractory bilateral essential tremor despite occurrence of acceptable adverse effects.
Identifiants
pubmed: 30771542
pii: S1878-8750(19)30336-5
doi: 10.1016/j.wneu.2019.01.224
pii:
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
e992-e997Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.