DBS for essential tremor
Deep brain stimulation is a well-established therapy for movement disorders. OHSU neurosurgeon Kim Burchiel, M.D., pioneered its use in the United States in 1991 with the first successful DBS surgery for Parkinson’s disease.
First to offer “asleep” DBS
In 2011, Dr. Burchiel developed a new method of implanting DBS electrodes to treat Parkinson's disease and essential tremor patients while they are under general anesthesia, and OHSU remains one of the few offering "asleep" DBS. Surgery under anesthesia allows for more precise placement of electrodes in the brain, as our experienced neurosurgical team matches the high-resolution, pre-surgery MRI scan with preoperative and intraoperative CT scans to locate the target exactly, without the trial and error necessary with patient feedback. Outcomes for asleep DBS are equally good, and patients are more comfortable with the procedure. OHSU no longer performs awake DBS procedures.
DBS for essential tremor reduction
DBS therapy is proven to reduce upper extremity tremor associated with essential tremor. The surgery is FDA-approved to treat one arm and hand, usually the hand used most often. DBS may reduce symptoms of action or resting tremor.¹ Patients who require frequent medication adjustments and have been diagnosed for more than four years, but less than 25 years, may be good DBS candidates.
View DBS data and clinical outcomes from Medtronic.
Quality of life improvement
After DBS, patients with essential tremor may have:
- Improved ability to do everyday activities, and less self-reported disability
- Less limb tremor
Research shows DBS improves patients’ quality of life more than medication alone.¹ Benefits may include:
- 24-hour therapy – does not wear off overnight as medications can
- Simpler medication routine
- Fewer potential drug-related side effects
- No daily maintenance (unless rechargeable system is chosen)
- No limitations on sleep position, intimacy, bathing or swimming, or clothing
Deep brain stimulation is reversible, unlike other surgical options such as pallidotomy and thalamotomy. The system may be turned off if desired, with components left in place for future treatment options.
OHSU uses Medtronic DBS systems that are FDA-approved for head MRI scans with appropriate safeguards. Patients may need these scans for common conditions such as vision or hearing loss, seizures, headache or stroke.
1Medtronic DBS Therapy for Parkinson's Disease and Essential Tremor Clinical Summary, 2013
Is your patient a candidate for DBS?
Patients with an essential (familial) tremor diagnosis are typically good candidates for DBS. Patients that do not respond to pharmacologic therapy, or whose anti-tremor medications cannot be given at a therapeutic dose because of side effects, should be considered for DBS. Patients must be referred by a primary care physician, neurologist or neurosurgeon.