Posterior subthalamic area deep brain stimulation for recurrent tremor after ventral intermediate nucleus thalamotomy: a case report

Abstract

Neurosurgical treatments, including both lesioning procedures and deep brain stimulation (DBS), are considered effective treatments for patients with intractable essential tremor (ET). However, it can be challenging to arrive at the decision to perform a second surgical attempt for recurrent ET after the initial neurosurgical treatment because of the uncertainty of successful results. We encountered a 49-year-old man who complained of recurrent tremor after ventral intermediate nucleus thalamotomy. The patient underwent DBS in the posterior subthalamic area (PSA), resulting in significantly reduced tremor and improved daily function. Although there are various surgical options for recurrent ET, DBS targeting the PSA induces favorable tremor control and can be successfully used as a salvage therapy after thalamotomy.