Diann Shaddox Foundation for Essential Tremor
Yesterday, a rainy Saturday, December 6 was an interesting day. I attended an Essential Tremor Seminar presented by Georgia Regents Movement Disorders specialists at Georgia Regents Medical Center, Augusta, GA.
There was a room full of people with Essential Tremor, including me, and a few people with Parkinson’s at the meeting to listen and ask the group of doctors, Dr. Cole Giller, Dr. John Morgan, Dr. Julie Kurek, and Brian Beck who is with Medtronic, questions.
John C. Morgan, MD, PhD, Department of Neurology began the meeting by explaining the symptoms of Essential Tremor, Dystonia, and Parkinson’s, how the tremors in each disorder are comparable, but so different in many ways. He continued to explain medications and the advantages and disadvantages of taking each of them.
Medications for Essential Tremor may include:
Drugs most commonly used to treat Essential Tremor include beta-blockers, propranolol, Inderal, and an epilepsy drug called Mysoline (primidone). Topamax is another drug used to treat epilepsy and migraine, helps some people. Sometimes drinking alcohol can decrease your tremor, but this is obviously not a useful long-term therapy.
Cole A. Giller, MD, PhD, MBA, FACS, Director, Functional and Stereotactic Neurosurgery explained the Surgery for Essential Tremor, Dystonia and Parkinson's and how it has come a long way since it was first developed more than 50 years ago. He discussed that surgery may be considered when drugs fail to control symptoms or cause severe or disabling side effects, but isn't for everyone.
If medication fails to control your symptoms or if medication side effects become intolerable, you may benefit from surgery. Like medication, surgery only treats symptoms of the disease. The usual surgery is called deep brain stimulation (DBS). This involves the precise placement of tiny electrodes into specific areas in your brain using a special technique (called minimally invasive) that uses specialized devices inserted into your body through small incisions. Wires on the electrodes are connected to a pacemaker-like device inserted under the skin of your chest. The electrodes stimulate parts of your brain and can relieve many of the most disabling symptoms of the disease.
Your neurologist will tell you if you may benefit from surgery. If so, you will have special tests, usually including an MRI scan. You’ll also have interviews with the surgeon to help make sure the surgery is as safe and effective as possible. You are awake for part of the surgery and asleep with anesthesia for another part. The surgical procedure takes place in an operating room and typically involves:
You will have follow-up visits to your neurologist for programming the pacemaker and adjusting your medications.
If you are considering surgery, you should ask questions about the procedure and follow-up care. Doctors are available to help you understand, make decisions and navigate the process.
A battery lasts for about three to five years and is relatively easy to replace under local anesthesia.
This surgery is only used when symptoms become severe or debilitating reducing the quality of your life. At this time, there is no cure for movement disorders. Stem cells and similar therapies offer hope for the future but remain unproven, (another post coming soon).
We, living with movement disorders, have to way out all the facts of which treatment will help your quality of life. That is a personal decision and shouldn’t be taken lightly.
Georgia Regents Health System
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