Deep Brain Stimulation for Intractable Involuntary Movement

Abstract

  Although essential tremor is considered the most common movement disorder, the incidence of other involuntary movements is infrequent during clinical practice. Stroke, brain tumor, and trauma occasionally cause secondary involuntary movements. Neurosurgeons who manage neurological disorders comprehensively should have the knowledge of diagnoses and treatment options for movement disorders. Deep brain stimulation (DBS) has become a standard therapy for the treatment of select cases of medication-refractory essential tremor and other involuntary movements. Traditionally, the ventralis intermedius nucleus (Vim) of the thalamus has been considered the main target for medically intractable tremors ; however alternative brain regions, such as posterior subthalamic area, and advances in hardware may change the current status. In lesion-related involuntary movements, DBS seems to be effective based on single cases or limited case series. DBS currently plays an essential role in therapeutic strategy for intractable involuntary movements.