Nieuwe operatieve behandelingen bij essentiële tremor

Essential tremor is a common and often progressive movement disorder that can lead to significant functional impairment, social isolation, and care dependency. Despite available treatments, patients are frequently referred late for advanced therapy. This article illustrates management options through two cases of patients with longstanding, medication-refractory tremor. Both experienced substantial disabilities affecting daily activities and quality of life. Patient A underwent deep brain stimulation (DBS), resulting in marked tremor reduction. Patient B underwent an MRI-guided focused ultrasound thalamotomy, achieving immediate and lasting unilateral tremor control without implantation of a device. Pharmacological therapy remains first-line but is often insufficient or limited by side effects. After failure of two adequately trialed medications, timely referral to a neurosurgical center is recommended. DBS and HIFU are effective, evidence-based treatments, each with distinct advantages and limitations. Earlier consideration of these interventions can significantly improve patient outcomes and quality of life.

Conflict of interest and financial support: ICMJE forms provided by the authors are available online along with the full text of this article.