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Essential Tremor Therapy: Does Deep Brain Stimulation Work?

It’s no fun to have shaky hands when you’re trying to button a button or bring a fork to your mouth. But such is the reality for people with essential tremor, a condition that affects up to 14 percent of people. Medications can subdue the tremor, but they don’t work for everyone — and there are potential side-effects. Now, there’s a new essential tremor therapy — a surgical procedure called deep brain stimulation.

Benign essential tremor: What is it?

Benign essential tremor is often an inherited disorder. A person with this condition develops a tremor in their hands and sometimes their head during late adolescence or adulthood, and it usually persists for the rest of their life. It’s a frustrating condition to treat, because even when medications work, they may become less effective over time. The symptoms can worsen as a person ages, making a task as simple as tying a shoe a challenge.

Deep brain stimulation: A new essential tremor therapy?

Deep brain stimulation involves implanting a pacemaker into the brain. Once implanted, the pacemaker sends signals to discrete portions of the brain to block abnormal signals that cause tremor.

When researchers reviewed the outcomes of 31 people who had deep brain stimulation to treat benign essential tremor, they discovered that 77 percent of them were able to stop their medications. The symptoms improved in the remaining people, but they stayed on their medication to control their blood pressure. Beta-blockers are frequently used for benign essential tremor — and to treat hypertension. All-in-all, in this small group of patients, deep brain stimulation was a highly effective treatment for essential tremor.

Is deep brain stimulation safe for benign essential tremor?

Doctors only treat one side of the brain with deep brain stimulation for essential tremor to decrease the risk of side-effects. They usually do the side of the brain that controls the dominant hand. People who get bilateral deep brain stimulation run the risk of psychiatric side-effects such as depression, anxiety, personality changes or hallucinations, although these symptoms are usually temporary.

The bottom line

Deep brain stimulation appears to be a promising therapy for treating essential tremor in people who don’t respond to medications. On the other hand, it’s still surgery and it’s a new procedure, so one knows whether the tremor will come back again 15 years down the road. Still, for people who have a severe tremor that don’t respond to medications, this surgery could boost their quality of life and may be worth the small risk of side-effects..
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