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Deep Brain Stimulation of the Ventral Intermediate Nucleus of the Thalamus for Control of Tremors in Parkinson's Disease and Essential Tremor. The beneficial effects of ventral intermediate nucleus (VIM) stimulation were evaluated in 20 patients with tremor refractory to medical therapy. Thalamic stimulation is a non-ablative procedure which has the advantage of a reversible, non-destructive lesion. 11 patients [7 with Parkinson's disease (PD) and 4 with essential tremor (ET)] received unilateral VIM implantation, while 9 patients had staged bilateral VIM implantation (4 with PD, 5 with ET). PD patients showed a significant improvement in contralateral arm and leg rest tremor and ipsilateral leg rest tremor (p < 0.02) at a mean follow-up period of 16.2 +/- 7.0 months. Patients with PD did not demonstrate any significant decrease in medication use at follow-up. ET patients demonstrated significant improvement in postural and action tremor in the contralateral arm (p <0.001), but no significant improvement in the contralateral leg tremor at follow-up. Significant improvements were also seen in ET patients in the Clinical Rating Scale for Tremor (p <0.001) with respect to several activities of daily living at a mean follow-up of 14.9 +/- 8.1 months. Deep brain stimulation is a safe and effective treatment for severe tremor refractory to medications. It is a highly effective, reversible, adaptable, and predictable procedure which avoids the complication of cognitive deficit seen in patients with bilateral thalamotomies. Copyright 2000 S. Karger AG, Basel Stereotact Funct Neurosurg 2000 Jan;72(1):47-61 Kumar K, Kelly M, Toth C Regina General Hospital, University of Saskatchewan, Regina, Canada. PMID: 10640920 http://www.ncbi.nlm.nih.gov/PubMed/ janet paterson 52 now / 41 dx / 37 onset a new voice: http://www.geocities.com/janet313/ 613 256 8340 PO Box 171 Almonte Ontario Canada K0A 1A0