Volume 21, Issue 3 p. 401-405
Brief Report

On-demand deep brain stimulation for essential tremor: A report on four cases

Martin Kronenbuerger MD

Corresponding Author

Martin Kronenbuerger MD

Department of Neurology, University Hospital, RWTH Aachen, Germany

Universitaetsklinikum Aachen, Neurologische Klinik, Pauwelsstr. 30, 52074 Aachen, GermanySearch for more papers by this author
Christoph Fromm MD

Christoph Fromm MD

Department of Neurology, University Hospital, RWTH Aachen, Germany

Search for more papers by this author
Frank Block MD

Frank Block MD

Department of Neurology, University Hospital, RWTH Aachen, Germany

Search for more papers by this author
Volker A. Coenen MD

Volker A. Coenen MD

Department of Neurosurgery, University Hospital, RWTH Aachen, Germany

Search for more papers by this author
Ina Rohde MD

Ina Rohde MD

Department of Neurosurgery, University Hospital, RWTH Aachen, Germany

Search for more papers by this author
Veit Rohde MD

Veit Rohde MD

Department of Neurosurgery, University Hospital, RWTH Aachen, Germany

Search for more papers by this author
Johannes Noth MD

Johannes Noth MD

Department of Neurology, University Hospital, RWTH Aachen, Germany

Search for more papers by this author
First published: 09 March 2006
Citations: 36

Abstract

Deep brain stimulation (DBS) is an established therapy for essential tremor (ET), but loss of efficacy due to tolerance can occur. Our objective was to evaluate if it is feasible to use DBS only on-demand and if this would prevent tolerance. We report on the effects of left-side thalamic DBS in 4 ET patients who were instructed to switch on stimulation only when using their right hand for motor tasks and were followed-up to 30 months after surgery. The patients were capable of using DBS only on-demand (DBS use of 22.0 ± 13.5%/day). DBS led to a stable suppression of right arm tremor throughout the follow-up. No problems associated with tolerance such as tremor rebound or late therapy failure occurred. In comparison to publications stating that ET patients had been using DBS continuously during the daytime, the use of on-demand DBS saves battery life, which delays surgical replacement of the stimulator. Thus, on-demand DBS saves money, may help to prevent tolerance, and should be adopted for the long-term treatment of ET patients. © 2005 Movement Disorder Society