Deep brain stimulation, or DBS, should be considered for patients whose essential tremor does not respond to traditional pharmacologic therapy such as propranolol or primidone. It should also be considered for patients for whom side effects preclude therapeutic doses of anti-tremor medication. The tremor must cause significant functional disability.
The importance of a definitive essential tremor diagnosis
Careful patient selection is the first and perhaps the most important step in successful DBS. It is important to have a definitive diagnosis of essential tremor, as it may be confused with other tremor subtypes for which DBS is not effective. Evaluation by an experienced multidisciplinary team specializing in movement disorders and experienced with essential tremor and deep brain stimulation is invaluable in screening patients for DBS.
Patient selection criteria
The chance of successful treatment is the most important factor in selecting patients with ET for deep brain stimulation. Patients who are marginal candidates, or whose multidisciplinary evaluation raises questions about risks versus benefits, will be informed, and our DBS team will discuss the issues with you.
OHSU provides an extensive workup for all potential deep brain stimulation candidates. This includes appointments with a neurologist and neurosurgeon.
The results of this multidisciplinary evaluation help us:
- Advise you and your patient on their DBS candidacy
- Analyze personal risks and benefits of DBS versus other treatments
- Use Medtronic's tool to help determine if your patient is a candidate for DBS