If medication no longer controls your essential tremor well, or causes severe side effects, it may be time to consider deep brain stimulation. The information on this page can help you learn whether you are a good candidate for DBS.
Who is a good candidate for DBS for essential tremor?
You could be a good candidate for DBS if:
- Medication no longer controls your essential tremor well, even at the highest recommended dose.
- You have tried combination medications – preferably a combination of a beta blocker, primidone and possibly a benzodiazepine.
- You have tried other medications that help some people with essential tremor.
- Your essential tremor is affecting your quality of life – for example, you have trouble doing daily activities, such as eating, drinking or getting dressed.
- Your medication causes strong side effects – these keep you from taking enough medication to control the tremor.
If you have essential tremor, you know it can cause two types of hand and arm tremor:
- Postural tremor, which happens when you hold your hands and arms in one position.
- Action tremor, which happens when you try to do something with your hands and arms.
You also know that action tremor can cause problems with simple but important tasks, like drinking or writing. If you have tried all the medication options available, and essential tremor interferes with your quality of life, you may be a DBS candidate.
Lastly, you must be able to have general anesthesia. OHSU is the ony major medical center in the Northwest offering "asleep" DBS under general anesthesia. We no longer perform awake DBS surgery for essential tremor at OHSU.
How can I know for sure if DBS could help?
If DBS could help, what else do I need to do?
You must stop taking aspirin, blood thinners and certain other medications several weeks before surgery. You must also be healthy enough for general anesthesia. OHSU is the only major medical center in the Northwest offering “asleep” DBS under general anesthesia. Learn more about why you don’t need to be awake during DBS surgery.
Who is not a good DBS candidate?
You are not a good candidate for DBS if:
- You need full-body MRI scans, or certain head and chest MRI scans.
- You cannot operate the internal pulse generator, also called the stimulator or IPG.
- Test stimulation does not work.
- You have certain brain conditions – such as ischemic brain disease, demyelinating brain disease or brain tumors.
- You are not healthy enough to have surgery.
What if I am not a DBS candidate?
If you are not a DBS candidate, the neurologist talks to your primary health care provider and recommends other treatment options. For example, changing your medications could help.