Objective: To review clinical characteristics of essential tremor (ET) in patients who underwent deep brain stimulation (DBS) surgery.
Background: DBS surgery is an effective treatment for patients with refractory ET. There has been an improvement in the surgical and programming technique over time. However, only a minority of patients with ET undergo DBS. We conducted a retrospective review of clinical characteristics of ET in patients who underwent DBS, to develop a better understanding of factors that may play an important role in the selection for this procedure.
Method: The Movement Disorders Clinical Case Registry at Parkinson Disease Research, Education and Clinical Center (PADRECC), Houston, was queried for patients with ICD-9 or 10 diagnostic codes of ET. Subjects were seen in PADRECC from September 1, 2001 – March 31, 2018. Charts were reviewed to verify the diagnosis of ET and surgery for DBS. Clinical data was abstracted from the records meeting the inclusion criteria.
Results: Of 1468 patients with at least one of the codes, 1051 (71.6%) had evidence of ET in the EMR, including information on treatment provided. Of the 1051 patients identified with ET, 42 (3.99%) were treated with DBS for medically refractory tremor. Within this male dominant cohort (100%) of 42 patients, mean age at onset of symptoms was 38.7±17.91, diagnosis occurring at mean age of 59.9± 12.6, and patients undergoing DBS at 68.4 years±7.8. Family history was positive in 64.10% of patients (n=25) while alcohol responsiveness was reported in 28.57% of the cohort (n=8). 68.57% of patients had head tremor (n=24). 57.14% of patients reported predominant tremor in the right hand (n=20), 22.85% had left predominant tremor (n=8) while 20% patient reported similar tremor on both sides (n=7). 67.64% patients were noted to have gait impairment (n=23). Most affected task was handwriting (n=17). Average number of medications taken before DBS surgery were 2.94 with a median of 3.0. Thirty percent (n=11) of patients received botulinum toxin surgery prior to undergoing DBS surgery.
Conclusion: This data identifies some of the key features of a cohort of military veterans with ET who underwent DBS surgery. The clinical significance of these features with respect to patient selection for DBS surgery remains to be defined.
To cite this abstract in AMA style:F. Jamal, I. Noorbhai, G. Jackson, A. Sarwar. Deep Brain Stimulation Surgery and Clinical Characteristics of Essential Tremor in a Cohort of Veterans [abstract]. Mov Disord. 2021; 36 (suppl 1). https://www.mdsabstracts.org/abstract/deep-brain-stimulation-surgery-and-clinical-characteristics-of-essential-tremor-in-a-cohort-of-veterans/. Accessed December 2, 2023.
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