Open AccessDeep Brain Stimulation of the Ventral Intermediate Nucleus of the Thalamus in Writer’s Cramp: A Case Report
Author(s) -
Lisa Hirt,
Fabio Grassia,
Jeanne Feuerstein,
John A. Thompson,
Steven Ojemann,
Drew S. Kern
Publication year - 2021
Publication title -
tremor and other hyperkinetic movements
Language(s) - English
Resource type - Journals
ISSN - 2160-8288
DOI - 10.5334/tohm.645
Subject(s) - deep brain stimulation , subthalamic nucleus , thalamotomy , medicine , thalamus , stimulation , dystonia , globus pallidus , essential tremor , thalamic stimulator , movement disorders , basal ganglia , psychology , surgery , physical medicine and rehabilitation , parkinson's disease , central nervous system , radiology , disease , psychiatry
Background: Globus pallidus internus (GPi) deep brain stimulation (DBS) and thalamotomy are interventions for writer’s cramp (WC). Ventralis intermedius nucleus (VIM) DBS is targeted for tremor, however, many aspects of VIM DBS remained underexplored in WC. Case Report: A 62-year-old man with WC underwent DBS. Dystonic tremor improved intraoperatively with ventralis oralis anterior (VoA)/ventral oralis posterior (VoP) and with subthalamic nucleus stimulation; although greatest benefit was obtained with VIM stimulation. Sustained benefit with VIM DBS at ten months post-operative was obtained. Discussion: This case demonstrates an intraoperative approach in target selection and supports benefits of VIM DBS for WC. Highlights: This case highlights the intraoperative approach and clinical effects of VIM DBS in the treatment of medically refractory writer’s cramp (WC). We contextualize our results from this case with previous reports of VoA/VoP stimulation for WC.