Thalamotomy

A thalamotomy is a procedure in which a small lesion about the size of a pea is created in a part of the brain called the thalamus. It is used most commonly to treat patients with essential tremor and tremor-dominant Parkinson’s Disease. Thalamotomy is an alternative to deep brain stimulation (DBS) and offers the advantage of not requiring a permanent implant.

There are several different techniques for performing thalamotomy, ranging from open surgery (radiofrequency) to Gamma Knife radiosurgery and focused ultrasound, which are two methods that do not require an incision or anesthesia.

Focused ultrasound is the most common form of thalamotomy performed at high-volume movement disorder centers in the US today - including Swedish Medical Center; there is only one other such device in the state of Colorado. I tend to use radiofrequency and Gamma Knife for patients who cannot have focused ultrasound for one reason or another. Thalamotomy can be life-changing treatment for the right patient with tremor.

 
MRI scan and improvement in writing ability during an MRI-guided focused ultrasound thalamotomy for essential tremor
Gamma Knife thalamotomy creates a tiny lesion in the brain (yellow arrow) in the circuit responsible for tremor. This is an MRI from patient I treated who had dramatic tremor relief.

Gamma Knife thalamotomy creates a tiny lesion in the brain (yellow arrow) in the circuit responsible for tremor. This is an MRI from patient I treated who had dramatic tremor relief.

 

I have a particular interest and specialized training in thalamotomy, and I am the director of movement disorder surgery at Swedish Medical Center.

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. Click here to read my education packet for patients considering surgery for essential tremor.