Last updated: 02/17/2009

Patients whose symptoms are well managed by drugs are not recommended for surgery, and significant effort will usually be made to adjust medications to control symptoms before surgery is considered.

Thalamotomy, surgery to the thalamus, was recommended...

in the past to control tremor. It is rarely performed today, and few centers would consider thalamotomy for any patient unless tremor was the only troubling and uncontrolled symptom.

Deep-brain stimulation (DBS) of the GPi is an alternative treatment in widespread use, as is DBS of another brain region, the subthalamic nucleus. Both procedures use permanemtly implanted, programmable electrodes to deliver a very small, continuous electric current to the target region. This has the same effect as a lesion, but is adjustable. DBS of the subthalamic nucleus typically produces better symtomatic results that either DBS to the GPi or pallidotomy. However, both forms of DBS carry the risk of long-term complications from the implanted hardware, as well as other risks.