Tremor Health Article

Tremor control therapy

Tremor control therapy is a type of treatment that uses mild electrical pulses to stimulate the brain. These pulses block the brain signals that trigger tremor. In this technique, the surgeon implants an electrode into a large oval area of gray matter within the brain that acts as a relay center for nerve impulses and is involved in generating movement (thalamus). The area that is particularly targeted for relief of tremor associated with PD is called the ventralis intermedius nucleus of the thalamus. The electrode is attached to an insulated wire that runs through the brain and exits the skull where it is attached to an extension wire. The extension is connected to a generator similar to a heart pacemaker. The generator is implanted under the skin in the chest, and the extension is tunneled under the skin from the skull to the generator. The patient can control his or her tremor by turning on the generator with a hand-held magnet to deliver an electronic pulse to the brain.

Some patients experience complete relief with this technique, but others receive no benefit at all. About 5% of patients experience complications from the surgical procedure, including bleeding in the brain. The procedure causes some discomfort, because patients must be awake while the implant is placed. Batteries must be replaced by surgical procedure every three to five years.

Other surgical treatments

A patient with extremely disabling tremor may find relief with a surgical technique called thalamotomy, in which the surgeon destroys part of the thalamus. However, the procedure produces such side effects as numbness, balance problems, or speech problems in a significant number of cases.

Pallidotomy is another type of surgical procedure sometimes used to decrease tremors from Parkinson's disease. In this technique, the surgeon destroys part of a small structure within the brain called the globus pallidus internus. The globus is part of the basal ganglia, another part of the brain that helps control movement. This surgical technique also carries the risk of permanent disabling side effects.

Fetal tissue transplantation (also called a nigral implant) is a controversial experimental method to treat Parkinson's disease symptoms. This method implants fetal brain tissue into the patient's brain to replace malfunctioning nerves. Unresolved issues include how to harvest the fetal tissue and the moral implications behind using such tissue, the danger of tissue rejection; and the amount of tissue required. Although initial studies using this technique looked promising, there has been difficulty in consistently reproducing positive results. More promising is the development of dopamine-producing cells from neuronal stem cells for transplantation into the brains of patients with PD. A method for producing these dopaminergic cells was patented in 2001.

Small amounts of alcohol may temporarily (sometimes dramatically) ease the shaking. Some experts recommend a small amount of alcohol (especially before dinner). The possible benefits, of course, must be weighed against the risks of alcohol abuse.