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