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目的虽然丘脑腹中间核(Vim)是治疗特发性震颤(ET)首选靶点,但是由于存在刺激耐受和其他副作用,因此需要探索新靶点。本文旨在探讨丘脑底核(STN)脑深部电刺激治疗ET的可能性。方法回顾性分析2例在北京天坛医院接受丘脑底核脑深部电刺激的ET病人的资料。病人接受立体定向手术,根据神经解剖图谱、术前MRI,术中微电极记录和测试以确定靶点。术后调节刺激参数以达到较好的控制效果和电池寿命。术后随访对治疗效果进行评价。结果 2例患者术中记录到典型的电信号,测试震颤明显减轻。术后震颤评分(FTMTRS)分别提高66.7%和75.5%。电极植入术后没有感染、出血、感觉异常、构音困难、认知和平衡障碍以及复视等副作用。结论丘脑底核也可以作为特发性震颤脑深部电刺激的备选治疗靶点。
Purpose Although the thalamic midbrain nucleus (Vim) is the preferred target for the treatment of idiopathic tremor (ET), new targets need to be explored due to stimulation tolerance and other side effects. This article aims to explore the subthalamic nucleus (STN) deep brain stimulation of the possibility of ET. Methods Two cases of ET patients receiving deep brain stimulation of subthalamic nucleus in Beijing Tiantan Hospital were retrospectively analyzed. The patient underwent stereotactic surgery to determine the target based on neuroanatomical maps, preoperative MRI, intraoperative microelectrode recording and testing. Postoperative stimulation parameters to achieve better control and battery life. Postoperative follow-up evaluation of the treatment effect. Results 2 patients recorded a typical electrical signal during surgery, test tremor significantly reduced. Postoperative tremor score (FTMTRS) increased by 66.7% and 75.5%. Electrode implantation without infection, bleeding, abnormal sensations, dysarthria, cognitive and balance disorders and diplopia and other side effects. Conclusion The subthalamic nucleus can also be used as an alternative therapeutic target for deep brain stimulation of essential tremor.