Gamma knife radiosurgery for essential tremor: A Case report and review of the literature
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CASE REPORT
WORLD JOURNAL OF SURGICAL ONCOLOGY
Open Access
Gamma knife radiosurgery for essential tremor: A Case report and review of the literature Ameer L Elaimy1,2, John J Demakas1,4, Benjamin J Arthurs1,3, Barton S Cooke1, Robert K Fairbanks1,5, Wayne T Lamoreaux1,5, Alexander R Mackay1,6, David R Greeley7, Christopher M Lee1,5*
Abstract Approximately 5 million people in America are affected by essential tremors (ET), which are classified as a type of benign movement disorder. This disease manifests as tremors that usually occur in the hands, but they may also be present in the head, face, tongue, and lower limbs. Radiofrequency thalamotomy (RF) and deep brain stimulation (DBS) are common invasive procedures with proven track records that are used to treat ET. Although these procedures have high success rates, they still put patients at risk of potential side effects and are invasive by nature. Thalamotomy using the gamma knife (GK) also produces favorable outcomes in treating tremors, without the complications associated with invasive neurosurgery procedures. This report describes the presenting symptoms and extended treatment outcome for a patient with an advanced case of ET, who received GK thalamotomy treatment six years ago. Because of this non-invasive treatment, she regained the ability to paint and live with an improved quality of life. We also discuss and review the relevant literature regarding the risks and benefits of this treatment modality. GK thalamotomy is one effective option for the treatment of ET, and due to its noninvasive nature, it has a different risk profile than neurosurgery. We suggest that GK thalamotomy should be presented as one viable treatment option to all ET patients, and should be recommended to those who would be best served by less invasive treatment techniques. Background Essential tremor is a common type of movement disorder that normally affects people over the age of 65; however, this illness can occur in younger patients as well. In recent years, ET has been categorized as a heritable condition, which can be transferred to family members in an autosomal dominant fashion [1]. The primary symptom of ET involves shaking of the hands during voluntary movements, but it may also present with movements of the head, face, tongue, and lower limbs [1-3]. Other than tremors, there are no other direct medical symptoms associated with ET and it does not decrease life expectancy. However, many patients with ET have difficulties accomplishing their daily tasks or other activities that affect quality of life, which is how this disorder elicits a negative impact on the social and mental wellness of the patients who bear this illness [1,4]. * Correspondence: [email protected] 1 Gamma Knife of Spokane, 910 W 5th Ave, Suite 102, Spokane, WA 99204, USA
There are multiple treatment options for ET patients. The most common medications utilized are beta-blockers. Unfortunately, these are contraindicated for many patients with asthma, diabetes, and certain heart conditions. Anti-seizure medicat
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