Publication year: 2011
Source: World Neurosurgery, Available online 10 December 2011
Patric Blomstedt, Peter Lindvall, Jan Linder, Magnus Olivecrona, Lars Forsgren, ...
ObjectiveTo evaluate the effects of re-operation 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 (ET).MethodsThe results of re-operation 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 re-operation Vim DBS improved hand-function and tremor in the treated hand with 25 %, while cZi DBS achieved an improvement of 57 %. Even though 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.ConclusionThe effect on tremor was in this small material improved by implanting an electrode in the cZi. The effect was modest in those patients suffering a deterioration years after the initial operation.
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