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Randomised controlled trial
Thalamotomy using MRI-guided focused ultrasound significantly improves contralateral symptoms and quality of life in essential tremor
  1. Ludvic Zrinzo
  1. Correspondence to : Dr Ludvic Zrinzo, Unit of Functional Neurosurgery, UCL Institute of Neurology, Queen Square, London, UK; l.zrinzo{at}ucl.ac.uk

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Propranolol and primidone significantly reduce tremor by around 60% in 50% of patients with essential tremor (ET). When medication is ineffective or causes intolerable side effects, neurosurgical intervention may be considered. Until recently, radiofrequency (RF) ablation or deep brain stimulation (DBS) of the ventralis intermedius (VIM) thalamic nucleus were the main surgical options. Gamma knife thalamotomy avoids a burrhole but delayed effects make intraoperative validation impossible.1 Recent technical advances have enabled transcranial delivery of high-intensity focused ultrasound to create a thalamotomy with MRI guidance and …

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