Abstract
Resting tremor is mainly observed in Parkinson’s disease, and postural tremor mainly corresponds to essential tremor. These two types of tremor are well known and generally respond very well to stereotactic techniques targeted on the ventral intermediate nucleus (Vim) of the thalamus: thalamotomy or Vim stimulation. As indicated in other chapters, the currently preferred stimulation techniques are associated with a much lower risk of neurological sequelae. The third main group of tremor consists of so-called action tremor. This type of tremor is more complex, comprising a postural tremor component and an intention tremor component. Action tremor generally has a larger amplitude than the other two forms and predominantly involves proximal muscles. Action tremor very rapidly becomes disabling and surgery may be considered soon after its onset. There are many causes of action tremor, but the leading causes are multiple sclerosis and head injury. Stereotactic techniques are the same as for Parkinsonian and essential tremor, but the results are generally less favorable, as the functional result largely depends on the neurological signs associated with the tremor: motor deficit, cognitive deficit, cerebellar syndrome, and especially dystonia, which is often present in these patients.
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References
Elbe RJ, Koller WC. Cerebellar tremor. In: Elbe RJ, Koller WC, editor. Tremor. Baltimore/London: The Johns Hopkins University Press; 1990. p. 106–17.
Sabra AF, Hallet M. Action tremor with alternating activity in antagonist muscles. Neurology 1984;34:151–6.
Koch M, Mostert J, Heersema D, De Keyser J. Tremor in multiple sclerosis. J Neurol 2007;254:133–45.
Rondot P, Jedynak CP, Ferrey G. Pathological tremors: nosological correlates. Prog Clin Neurophysiol 1978;5:95–113.
Waubant E, Tezenas du Montcel S, Jedynak C, Obadia M, Hosseini H, Damier P, Lubetzki C, Agid Y, Degos JD. Multiple sclerosis tremor and the Stewart-Holmes manoeuvre. Mov Disord 2003;18:948–52.
Anouti A, Koller WC. Tremor disorders. Diagnosis and management. West J Med 1995;162:510–13.
Geny C, Nguyen JP, Cesaro P, Goujon C, Brugières P, Degos JD. Thalamic stimulation for severe action tremor after lesion of the superior cerebellar peduncle. J Neurol Neurosurg Psychiatry 1995;59:641–2.
Remy P, de Recondo A, Defer G, Loc’h C, Amarenco P, Plante-Bordeneuve V, Dao-Castellana MH, Bendriem B, Crouzel C, Clanet M. Peduncular “rubral” tremor and dopaminergic denervation: a PET study. Neurology 1995;45:472–7.
Ohye C, Shibazaki T, Hirai T, Kawashima Y, Hirato M, Matsumura M. Tremor mediating thalamic zone studied in humans and in monkeys. Stereotact Func Neurosurg 1993;60:136–45.
Axelrad JE, Louis ED, Honig LS, Flores I, Ross GW, Pahwa R, Lyons KE, Faust PL, Vonsattel JP. Reduced Purkinje cell number in essential tremor: a postmortem study. Arch Neurol 2008;65:101–7.
Kralic JE, Criswell HE, Osterman JL, O’Buckley TK, Wilkie ME, Matthews DB, Hame K, Breese GR, Homanics GE, Morrow AL. Genetic essential tremor in gamma-aminobutyric acidA receptor alpha1 subunit knockout mice. J Clin Invest 2005;115:584–6.
Louis ED. A new twist for stopping the shakes? Revisiting GABAergic therapy for essential tremor. Arch Neurol 1999;56:807–8.
Bauer HJ. Problems of symptomatic therapy in multiple sclerosis. Neurology 1978;28:8–20.
Kelly R. Clinical aspects of multiple sclerosis. In Handbook of clinical neurology: demyelinating diseases, vol. 3. New York: Elsevier Science Publishers; 1988. p. 49–78.
Alusi SH, Glickman S, Aziz TZ. Tremor in multiple sclerosis. J Neurol Neurosurg Psychiatry 1999;66:131–4.
Pittock SJ, McClelland RL, Mayr WT, Rodriguez M, Matsumoto JY. Prevalence of tremor in multiple sclerosis and associated disability in the Olmsted County population. Mov Disord 2004;19:1482–5.
Alusi SH, Worthington J, Glickman S, Bain PG. A study of tremor in multiple sclerosis. Brain 2001;124:720–30.
Bozec CB, Kastrukoff LF, Wright JM, Perry TL, Larsen TA. A controlled trial of iszoniazid therapy for action tremor in multiple sclerosis. J Neurol 1987;234:36–9.
Tranchant C, Bhatia P, Marsden CD. Movement disorders in multiple sclerosis. Mov Disord 1995;4:418–23.
Nardocci N, Zorzi G, Savoldelli M, Rumi V, Angelini L. Paroxysmal dystonia and proximal tremor in a young patient with multiple sclerosis. Ital J Neurol Sci 1995;16:315–9.
Krauss JK, Mohadjer M, Nobbe F, Mundinger F. The treatment of post-traumatic tremor by stereotactic surgery. Symptomatic and functional outcome in a series of 35 patients. J Neurosurg 1994;80:810–19.
Krauss JK, Jankovic J. Head injury and posttraumatic movement disorders. Neurosurgery 2002;50:927–40.
Haggard P, Miall C, Wade D, Fowler S, Richardson A, Anslow P, Stein J. Damage to cerebellocortical pathways after closed head injury: a behavioural and magnetic resonance imaging study. J Neurol Neurosurg Psychiatry 1995;58:439–43.
Lee MS, Marsden CD. Movement disorders following lesions of the thalamus or subthalamic region. Mov Disord 1994;5:493–507.
Luijckx GJ, Boiten J, Lodder J, Heuts-van Raak L, Wilmink J. Isolated hemiataxia after supratentorial brain infarction. J Neurol Neurosurg Psychiatry 1994;57:742–4.
Payne MS, Brown BL, Rao J, Payne BR. Treatment of phenylketonuria-associated tremor with deep brain stimulation: case report. Neurosurgery 2005;56:E868.
Ruzicka E, Jech R, Zarubova K, Roth J, Urgosik D. VIM thalamic stimulation for tremor in a patient with IgM paraproteinaemic demyelinating neuropathy. Mov Disord 2003;18:1192–5.
Pal PK, Sinha S, Pillai S, Taly AB, Abraham RG. Successful treatment of tremor in Wilson’s disease by thalamotomy: a case report. Mov Disord 2007;22:2287–90.
Freund HJ, Barnikol UB, Nolte D, Treuer H, Auburger G, Tass PA, Samii M, Sturm V. Subthalamic-thalamic DBS in a case with spinocerebellar ataxia type 2 and severe tremor-a unusual clinical benefit. Mov Disord 2007;22:732–5.
Webster DD. Critical analysis of the disability in Parkinson’s disease. Mod Treat 1968;5:257–82.
Spieker S, Boose A, Jentgens C, Dichgans J. Long-term recordings in parkinsonian and essential tremor. J Neural Transm 1995;46:339–49.
Bain PG, Findley LJ, Atchison P, Behari M, Vidailhet M, Gresty M, Rothwell JC, Thompson PD, Marsden CD. Assessing tremor severity. J Neurol Neurosurg Psychiatry 1993;56:868–73.
Berck C, Carr J, Sinden M, Martzke J, Honey CR. Thalamic deep brain stimulation for the treatment of tremor due to multiple sclerosis: a prospective study of tremor and quality of life. J Neurosurg 2002;97:815–20.
Bain PG, Findley LJ. Spirography. In: Bain PJ, Findley LJ, editors. Standards in neurology. Book 1: Assessing tremor severity. London: Smith-Gordon; 1993. p. 9–19.
Elbe RJ, Brilliant M, Leffler K, Higgins C. Quantification of essential tremor in writing and drawing. Mov Disord 1996;11:70–8.
Geny C, Nguyen JP, Pollin B, Fève A, Ricolfi F, Cesaro P, Degos JD. Improvement of severe postural cerebellar tremor in multiple sclerosis by chronic thalamic stimulation. Mov Disord 1996;11:489–94.
Mathieu D, Kondziolka D, Nirajan A, Flickinger J, Lunsford D. Gamma knife thalamotomy for multiple sclerosis tremor. Surgical neurol 2007;68:394–9.
Nguyen JP, Pollin B, Fève A, Geny C, Cesaro P. Improvement of action tremor by chronic cortical stimulation. Mov Disord 1998;13:84–8.
Jankovic C, Cardoso F, Grosmann RG, Hamilton WJ. Outcome after stereotactic thalamotomy for parkinsonian, essential, and other types of tremor. Neurosurgery 1995;37:680–7.
Benabid AL, Pollak P, Gao D, Hoffman D, Limousin P, Gay E, Payan I, Benazzouz A. Chronic electrical stimulation of the ventralis intermedius nucleus of the thalamus as a treatment for movement disorders. J Neurosurg 1996;84:203–14.
Fahn S, Elton RL, UPDRS development committee. Unified Parkinson’s disease rating scale. In: Fahn S, Marsden CD, Goldstein M, Calne DM, editors. Recent developments in Parkinson’s disease. Florham Park, NJ: Macmillan Health Care Information; 1987. p. 153–64.
Siegfried J, Lippitz B. Chronic electrical stimulation of the VL-VPL complex and of the pallidum in the treatment of movement disorders: personal experience since 1982. Stereotact Funct Neurosurg 1994;62:71–5.
Kurtzke JF. Rating neurological impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology 1983;33:1444–52.
Capparos-Lefebvre D, Blond S, Nguyen JP, Pollak P, Benabid AL. Chronic deep brain stimulation for movement disorders. In: Cohadon F, editor. Advances and technical standards in neurosurgery, vol. 25. Vienna: Springer; 1999. p. 61–138.
Brown RJ, MacCarthy B, Jahanshahi M. Accuracy of self reported disability in patients with parkinsonism. Arch neurol 1989;46:955–9.
Derome PJ, Jedynak CP, Visot A, Delalande O. Treatment of involuntary movements by thalamic lesions. Rev Neurol 1986;142:391–7.
Nguyen JP, Degos JD. Thalamic stimulation and proximal tremor. A specific target in the ventrointermedius thalami. Arch Neurol 1993;50:498–500.
Ohye C, Shibazaki T, Hirai T, Wada H, Hirato M, Kawashima Y. Further physiological observations on the ventralis intermedius neurons in the human thalamus. J Neurophysiol 1989;61:488–500.
Whittle IR, Yau YH, Hooper J. Mesodiencephalic targeting of stimulating electrodes in patients with tremor caused by multiple sclerosis. J Neurol Neurosurg Psychiatry 2004;75:1210.
Nandi D, Liu X, Bain P, Parkin S, Joint C, Winter J, Stein J, Scott R, Gregory R, Aziz T. Electrophysiological confirmation of the zona incerta as a target for surgical treatment oàf disabling involuntary arm movements in multiple sclerosis: use of local field potentials. J Clin Neurosci 2002;9:64–8.
Plaha P, Khan S, Gill SS. Bilateral stimulation of the caudal zona incerta nucleus for tremor control. J Neurol Neurosurg Psychiatry 2008;79:504–13.
Hamel W, Herzog J, Kopper F, Pinsker M, Weinert D, Müller D, Krack P, Deuschl G, Mehdorn HM. Deep brain stimulation in the subthalamic area is more effective than nucleus ventralis intermedius stimulation for bilateral intention tremor. Acta Neurochir 2007;149:749–58.
Foote KD, Okun MS. Ventralis intermedius plus ventralis oralis anterior and posterior deep brain stimulation for posttraumatic Holmes tremor: two leads may be better than one: technical note. Neurosurgery 2005;56:E445.
Lim DA, Khandhar SM, Heath S, Ostrem JL, Ringel N, Starr P. Multiple target deep brain stimulation for multiple sclerosis related and poststroke Holmes’ tremor. Stereotact Funct Neurosurg 2007;85:144–9.
Bittar RG, Hyam J, Nandi D, Wang SY, Liu X, Joint C, Bain PG, Gregory R, Stein J, Aziz TZ. Thalamotomy versus thalamic stimulation for multiple sclerosis tremor. J Clin Neurosci 2005;12:638–42.
Yap L, Kouyialis A, Varma TR. Stereotactic neurosurgery for disabling tremor in multiple sclerosis: thalamotomy or deep brain stimulation ? Br J Neurosurg 2007;21:349–54.
Sandyk R, Dann LC. Weak electromagnetic fields attenuate tremor in multiple sclerosis. Int J Neurosci 1994;79:199–212.
Marrosu F, Maleci A, Cocco E, Puligheddu M, Barberini L, Marrosu MG. Vagal nerve stimulation improves cerebellar tremor and dysphagia in multiple sclerosis. Mult Scler 2007;13:1200–2.
Alusi SH, Aziz TZ, Glickman S, Jahanshahi M, Stein JF, Bain PG. Stereotactic lesional surgery for the treatment of tremor in multiple sclerosis: a prospective case-controlled study. Brain 2001;124:1576–89.
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Nguyen, J.P., Raoul, S., Deligny, C., Roualdes, V., Keravel, Y. (2009). Management of Tremors other than Essential Tremor and Parkinson’s Disease. In: Lozano, A.M., Gildenberg, P.L., Tasker, R.R. (eds) Textbook of Stereotactic and Functional Neurosurgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-69960-6_105
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DOI: https://doi.org/10.1007/978-3-540-69960-6_105
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