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Most patients stop drugs for essential tremor after deep brain stimulation surgery
Date:4/7/2011

been diagnosed for less than 10 years.

The researchers found that all 13 patients still taking anti-tremor medications at the time of DBS surgery gained effective control of their tremors following the procedure. In fact, symptom improvement was so good that 10 patients in this group (77 percent) stopped the anti-tremor medications within one year of surgery. The remaining three (23 percent) continued to take propranolol, an antihypertensive as well as an anti-tremor drug, only because they still needed it to control blood pressure.

Eighteen of the 31 patients (54 percent) had discontinued anti-tremor medications a year or more before the DBS surgery 10 because the medications stopped working and eight because of adverse side effects such as nausea, headaches and other flu-like symptoms, drops in blood pressure, cognitive impairment or depression. Most patients in this group had long-standing essential tremor (10 or more years). All these patients also benefitted from the DBS surgery, though some experienced longer symptom improvement than others.

USF Health neurosurgeon Dr. Donald Smith, a pioneer in DBS surgery, has performed more than 200 procedures since the FDA approved the anti-tremor treatment in 1997.

By the time patients reach the point of contemplating surgery, the tremors are usually very debilitating, said Dr. Smith, surgical co-director of the Movement Disorders Clinic in the USF Department of Neurosurgery.

"People may not be able to write, or comb their hair; they can't use tools, can't sew or knit. They have difficult feeding themselves and drinking, so they're often embarrassed to go out to eat." Dr Smith said. "It a rewarding procedure to perform, because most patients come in with high levels of disability and can be turned around quickly. It's a home-run surgery."

A limitation of the USF study was that only unilateral DBS, which treats one side of the brain affecting tremors in the do
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Contact: Anne DeLotto Baier
abaier@health.usf.edu
813-974-3300
University of South Florida (USF Health)
Source:Eurekalert  

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