RADIOFREQUENCY ABLATION FOR SEVERE BILATERAL HAND TREMORS

Clinical Presentation

78-year-old male with several years of severe, progressive bilateral essential hand tremors, significantly affecting eating. drinking, writing and other daily activities. Previous medications provided inadequate symptom control.

Treatment Planning

After neurological assessment and stereotactic imaging, Radiofrequency (RF) Vim Thalamotomy was planned. A staged bilateral approach was selected, treating one hand at a time.

Procedure

• Stage 1: Right VIM Thalamotomy
• Stage 2: Left VIM Thalamotomy, approximately 1 year later

The procedure was performed using stereotactic targeting with intraoperative neurological assessment and RF lesioning. No intraoperative complications were reported.

Postoperative Outcome

Immediate and significant tremor reduction Improved hand stability Independent eating, drinking and writing. No significant neurological deficits reported Smooth recovery after both procedures

Results

Excellent bilateral tremor control

• Improved hand function
• Independence restored
• No neurological deficits
• No reported complications

Conclusion

Staged bilateral RF VIM Thalamotomy provided significant and sustained tremor control in this patient with severe, medication-refractory essential tremor.