Deep brain stimulation for tremor and dystonia

Deep brain stimulation is a treatment option for tremor and dystonia (excluding Parkinson's disease).

• the safety and efficacy of deep brain stimulation for tremor and dystonia (excluding Parkinson’s disease) appears adequate to support the use of this procedure (1)
• deep brain stimulation can be carried out on structures within the brain that are responsible for modifying movements, such as the thalamus, the globus pallidus and the subthalamic nucleus, which interact functionally with the substantia negra (nigra)
  • these structures are all bilateral, and surgery can be performed on one or both sides
  • function of these brain nuclei is altered during deep brain stimulation through the application of an electrical current
  • procedure involves inserting fine needles into the brain through small holes in the skull under imaging guidance, to determine the exact position of the targeted nucleus, which may be different in each patient. One or more permanent electrodes are subsequently placed into this nucleus. Wires are tunnelled subcutaneously to the anterior chest wall, where they are connected to an implanted pulse generator
  • local or general anaesthetic may be used in this procedure

Reference:

1. NICE (August 2006).Deep brain stimulation for tremor and dystonia (excluding Parkinson’s disease).