Treatment of Essential Tremor with Stereotactic Radiosurgery Presenter: Christopher Loiselle, MD Poster # 1024

Treatment of Essential Tremor with Stereotactic Radiosurgery Very common (5% population > age 65) Primarily an action tremor 95% of the time affects hands Can be disabling leading to basic activities such as writing, drinking, eating, cooking, using utensils, brushing teeth, holding a tray. Familial in 60% Pathophysiologic recordings of VIM thalamus demonstrate neurons that dischage excessively and synchronously

Treatment of Essential Tremor with Stereotactic Radiosurgery Treatment options: medical therapy, deep brain stimulation, radiosurgical thalamotomy Radiosurgical thalamotomy is an ideal treatment for patients with medically refractory disease who are not candidates for deep brain stimulation

Treatment of Essential Tremor with Stereotactic Radiosurgery Current retrospective series: 99 thalamotomies with the Gamma Knife in 94 patients 77% of cases had major improvement in drawing 81% of cases had major improvement in writing 7 patients developed side effects following treatment including contralateral numbness, contralateral weakness, or speech difficulty. One patient’s side effects resolved during the followup period.

Treatment of Essential Tremor with Stereotactic Radiosurgery For patients with a positive result (about 80%), the benefits of treatment are a remarkable improvement in life quality The future: Prospective studies Development of patient selection tools and/or treatment techniques to further minimize potential side effects.