Pallidal stimulation for Holmes tremor: clinical outcomes and single-unit recordings in 4 cases

Journal of Neurosurgery
Camilla KilbaneJill L Ostrem

Abstract

Holmes tremor (HT) is characterized by irregular, low-frequency (< 4.5 Hz) tremor occurring at rest, with posture, and with certain actions, often affecting proximal muscles. Previous reports have tended to highlight the use of thalamic deep brain stimulation (DBS) in cases of medication-refractory HT. In this study, the authors report the clinical outcome and analysis of single-unit recordings in patients with medication-refractory HT treated with globus pallidus internus (GPi) DBS. The authors retrospectively reviewed the medical charts of 4 patients treated with pallidal DBS for medication-refractory HT at the University of California, San Francisco, and San Francisco Veterans Affairs Medical Center. Clinical outcomes were measured at baseline and after surgery using an abbreviated motor-severity Fahn-Tolosa-Marin (FTM) tremor rating scale. Intraoperative microelectrode recordings were performed with patients in the awake state. The neurophysiological characteristics identified in HT were then also compared with characteristics previously described in Parkinson's disease (PD) studied at the authors' institution. The mean percentage improvement in tremor motor severity was 78.87% (range 59.9%-94.4%) as measured using the FTM ...Continue Reading

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Citations

Sep 26, 2015·Journal of Neurosurgery·Takashi MorishitaTooru Inoue
Jun 3, 2016·Expert Review of Neurotherapeutics·Lazzaro di Biase, Renato Puppi Munhoz
May 27, 2016·Expert Review of Neurotherapeutics·Adolfo Ramirez-Zamora, Michael S Okun
Dec 22, 2017·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·E BudmanA Ramirez-Zamora
Mar 8, 2018·Journal of Neurology·Carlo Alberto ArtusiAristide Merola
Aug 5, 2019·Brain : a Journal of Neurology·Bassam Al-FatlyAndrea A Kühn
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Jan 4, 2021·Neuromodulation : Journal of the International Neuromodulation Society·Panagiotis BargiotasM Lenard Lachenmayer
Feb 23, 2021·American Journal of Industrial Medicine·Jonathan RutchikMarcia H Ratner

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