DBS for Essential Tremor
In essential tremor (ET), deep brain stimulation can have a transformative effect on quality of life because of the high rate of symptom control.
The vast majority of patients experience a significant improvement in tremor allowing them to perform their work or their hobbies. Others have reported being able to enjoy meals with family and friends after DBS due to tremor control.
Unfortunately, medications are only partially effective for essential tremor, and often have a high rate of side effect. Medications remain first-line treatment but if the typical ET medications (propranolol, primidone, gabapentin) have been tried and failed, DBS is an excellent option for symptom control.
Who is a good candidate for DBS?
- Disabling tremor
- Incomplete response to medications
- Unable to tolerate medications
- Absence of dementia or severe depression
- Normal MRI for age
- Good medical health
- Realistic expectations
Potential benefits of DBS
On average, tremor is 75% reduced with appropriate programming resulting in improvement in quality of life, with sustained benefit over years.
Potential risks of DBS
Post-operative headache and pain are possible but typically resolve gradually a few weeks after the procedure. Neck pain is also possible in the short term. Infection of the leads, extension or battery is very low risk and our surgical team does their utmost to prevent this. Hemorrhage is extremely low risk but when it occurs may lead to stroke-like symptoms. Most frequently, hemorrhage does not result in permanent complications. Lead fracture or migration, also very low risk, may require repeat surgery.
Problems with speech, language and mood, muscle tightness, slurred speech and vision symptoms can be related to the stimulation and thus can usually be reduced or eliminated by adjusting the stimulation.