Radiofrequency (RF) Thalamotomy

Radiofrequency (RF) thalamotomy is a surgery used for treating patients with essential tremor and Parkinson’s disease. The procedure is a type of thalamotomy and involves creating a tiny lesion - about the size of a pea - in the brain. This lesion interrupts the brain circuit that causes tremor. Other techniques for performing a thalamotomy include MRI-guided focused ultrasound and Gamma Knife.

RF thalamotomy is performed in the operating room with the patient awake, and it takes about an hour. A tiny strip of hair about the size of a band-aid is shaved, and a millimeter-wide probe is inserted into the thalamus. The patient is tested for tremor relief and for side effects, and then a series of 2-3 lesions is made by heating up the tip of the probe. These lesions are painless, and each takes about 60 seconds. The probe is then removed. Patients are monitored in the hospital overnight and are generally able to leave the following morning.

Advantages of RF thalamotomy include the immediate effect (versus Gamma Knife), minimal hair shave (versus focused ultrasound), and lack of need for any permanent medical device implant (versus deep brain stimulation (DBS)). Studies suggest that RF thalamotomy is similar in effectiveness to focused ultrasound and likely superior to Gamma Knife. Thalamotomy - whether RF, ultrasound, or Gamma Knife - tends to be less effective for tremor than DBS, however.

While RF thalamotomy is mostly intended for treating patients with essential tremor, the procedure can also be used for Parkinson’s Disease in certain cases.

If you live near Denver and have essential tremor or Parkinson’s Disease, please consider meeting me in consultation to learn about your treatment options.