Tremor-Dominant Parkinson Disease

Abstract

Abstract Deep brain stimulation is an evidence-based treatment for Parkinson disease that has been shown to improve quality of life along multiple domains. Though ablation may be considered in patients with unilateral tremor dominance, deep brain stimulation has evolved as the dominant therapy as it can be performed bilaterally and can be adjusted with time. For patients with tremor as the dominant symptom, stimulation of the ventralis intermedius nucleus of the thalamus may be considered. For patients with tremor along with refractory bradykinesia or rigidity, stimulation of the subthalamic nucleus or globus pallidus internus can improve both the tremor and the other cardinal motor features of Parkinson disease.