Thalamotomy for Parkinson's Disease

Surgery Overview

Thalamotomy is surgery to destroy a tiny area of the brain called the thalamus that controls some involuntary movements. Before surgery, detailed brain scans using a CT scan or an MRI are done to find the precise location for treatment.

Surgery on one side of the brain affects the opposite side of the body. If you have tremor in your right hand, for instance, the left side of your brain will be treated.

What To Expect

The surgery usually requires a 2-day hospital stay. Most people recover completely within about 6 weeks.

Why It Is Done

Thalamotomy is rarely done today. It may be used to treat severe tremor on one side of the body (most often in an arm or leg) that does not respond to medicines. It doesn't help with slow movement (bradykinesia), speech problems, or trouble with walking. Deep brain stimulation is often used instead of thalamotomy, because it doesn't destroy brain tissue and it has fewer side effects.

How Well It Works

In most people, thalamotomy can improve tremor. There is no evidence that it works for other symptoms of Parkinson's disease.footnote 1

Risks

Permanent problems from thalamotomy can include:

  • Trouble moving one side of the body.
  • Trouble with speech.
  • Problems with balance.
  • Trouble thinking or problem-solving.

Short-term problems can include:

  • Motor problems (trouble moving like you want to).
  • Trouble speaking well.
  • Weakness.
  • Confusion.
  • Sleepiness.
  • Weakness of the facial muscles that can cause drooping.

Related Information

References

Citations

  1. Schuurman PR, et al. (2000). A comparison of continuous thalamic stimulation and thalamotomy for suppression of severe tremor. New England Journal of Medicine, 342(7): 461–468. DOI: 10.1056/NEJM20000217342070.

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