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Long‐term deep brain stimulation for essential tremor: 12‐year clinicopathologic follow‐up
Author(s) -
DiLorenzo Daniel J.,
Jankovic Joseph,
Simpson Richard K.,
Takei Hidehiro,
Powell Suzanne Z.
Publication year - 2010
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.22935
Subject(s) - gliosis , deep brain stimulation , autopsy , intention tremor , medicine , pathology , giant cell , essential tremor , neurological examination , surgery , ataxia , parkinson's disease , disease , psychiatry , physical medicine and rehabilitation
We describe the clinical course and postmortem pathological findings in a patient with essential tremor (ET) treated with deep brain stimulation (DBS) for 12 years. This 75 year old woman had a 13‐year history of progressive ET prior to implantation of bilateral quadripolar DBS electrodes in the region of her ventral intermediate thalamic nuclei in 1996, producing immediate relief of arm tremor. Histopathological examination of the brain, performed 12 years after the initial implantation, demonstrated electrode catheter tracts rimmed by 20‐25 micron fibrous sheaths, with multinucleated giant cells and reactive gliosis. Lymphocytic infiltration was seen by L26 immunoreactivity with CD3 (T cells) staining predominating over CD20 (B cells). Cerebellar axonal spheroids and Purkinje cell loss were found. The minimal foreign body reaction and gliosis around the electrodes 12 years after implantation supports the long‐term safety of DBS. The case represents the longest reported follow‐up with autopsy examination after DBS and confirmed histological changes associated with ET. © 2009 Movement Disorder Society