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Peraio S, Mantovani G, Araceli T, Mongardi L, Noris A, Fino E, Formica F, Piccinini L, Melani F, Lenge M, Scalise R, Battini R, Di Rita A, D'Incerti L, Appleton T, Cavallo MA, Guerrini R, Giordano F. Unilateral deep brain stimulation (DBS) of nucleus ventralis intermedius thalami (Vim) for the treatment of post-traumatic tremor in children: a multicentre experience. Childs Nerv Syst 2024:10.1007/s00381-024-06380-1. [PMID: 38573550 DOI: 10.1007/s00381-024-06380-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 03/26/2024] [Indexed: 04/05/2024]
Abstract
PURPOSE Deep brain stimulation (DBS) of nucleus ventralis intermedius thalami (Vim) is a validated technique for the treatment of essential tremor (ET) in adults. Conversely, its use for post traumatic tremor (PTT) and in paediatric patients is still debated. We evaluated the efficacy of Vim-DBS for lesional tremor in three paediatric patients with drug-resistant post-traumatic unilateral tremor. METHODS We retrospectively collected data regarding three patients with unilateral tremor due to severe head injury, with no MRI evidence of basal ganglia lesions. The three patients underwent stereotactic frame-based robot-assisted DBS of Vim contralateral to the tremor side. RESULTS Mean follow-up was 48 months (range: 36-60 months). Tremor was reduced in all patients with a better control of voluntary movements and improvement of functional status (mean FIM scale improvement + 7 points). No surgical complications occurred. CONCLUSION Unilateral contralateral DBS of Vim could be efficacious in post-traumatic tremor, even in paediatric patients and should be offered in PTT drug-resistant patients.
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Affiliation(s)
- Simone Peraio
- Department of Neurosurgery, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Giorgio Mantovani
- Department of Translational Medicine and for Romagna, University of Ferrara, Ferrara, Italy
| | - Tommaso Araceli
- Department of Neurosurgery, Meyer Children's Hospital IRCCS, Florence, Italy
- Department of Neurosurgery, University Hospital Regensburg, Regensburg, Germany
| | - Lorenzo Mongardi
- Department of Translational Medicine and for Romagna, University of Ferrara, Ferrara, Italy
| | - Alice Noris
- Department of Neurosurgery, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Edoardo Fino
- Pediatric Neurology Clinic - Meyer Children's Hospital IRCCS, Florence, Italy
- University of Florence, Florence, Italy
| | - Francesca Formica
- Istituto Medea "La Nostra Famiglia" IRCCS, Bosisio Parini, LC, Italy
| | - Luigi Piccinini
- Istituto Medea "La Nostra Famiglia" IRCCS, Bosisio Parini, LC, Italy
| | - Federico Melani
- Pediatric Neurology Clinic - Meyer Children's Hospital IRCCS, Florence, Italy
| | - Matteo Lenge
- Pediatric Neurology Clinic - Meyer Children's Hospital IRCCS, Florence, Italy.
| | - Roberta Scalise
- Istituto Stella Maris - IRCCS - University of Pisa, Pisa, Italy
| | - Roberta Battini
- Istituto Stella Maris - IRCCS - University of Pisa, Pisa, Italy
| | - Andrea Di Rita
- Department of Neurosurgery, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Ludovico D'Incerti
- Department of Radiology, Meyer Children's Hospital IRCCS, Florence, Italy
| | | | | | - Renzo Guerrini
- Pediatric Neurology Clinic - Meyer Children's Hospital IRCCS, Florence, Italy
- University of Florence, Florence, Italy
| | - Flavio Giordano
- Department of Neurosurgery, Meyer Children's Hospital IRCCS, Florence, Italy
- University of Florence, Florence, Italy
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