TY - JOUR AU - Young, Ronald F. AU - Hesselgesser, Robert D. AU - Ahn, Eugene AU - Vermeulen, Sandra AU - Li, Francisco AU - Lee, Jesse PY - 2014 TI - Bilateral Gamma Knife thalamotomy for treatment of axial tremor JF - Translational Cancer Research; Vol 3, No 6 (December 04, 2014): Translational Cancer Research Y2 - 2014 KW - N2 - Objective: The objective of this report is to describe the effect of both unilateral and bilateral Gamma Knife thalamotomy (GKT) on axial tremor. Methods: Sixty-eight patients with essential tremor (ET) either only or predominantly affecting axial structures, including the head and neck, voice or lower jar, underwent staged bilateral GKT using previously described methods. A single lesion was made during each GKT procedure in the ventral intermediate (VIM) thalamic nucleus using one 4-mm collimator isocenter, and a maximum radiosurgical dose of 140 Gy. All patients had failed prior medical management. Tremor was graded on a five step scale [0-4] by a comprehensive movement disorder team before treatment, after unilateral thalamotomy and again after bilateral thalamotomy. Results: There were statistically significant improvements in head, voice and lower jaw tremor after bilateral GKT (P<0.05 or better). The average amount of improvement in tremor score was 60.86%. Two patients experienced complications which included speech, balance and gait problems of the total 136 procedures (1.5%). Minimum follow up was 18 months and mean follow up was 65 months. Conclusions: Although bilateral radiofrequency thalamotomy (RFT) carries a high risk of complications, bilateral GKT can be performed safely with appropriate safe guards. Improvements in axial tremor following bilateral GKT are comparable to those seen after bilateral deep brain stimulation (DBS) but with a lower complication rate. UR - https://tcr.amegroups.org/article/view/3432