特发性震颤的微电极导向射频治疗

Treatment of essential tremor with microelectrode targeting radiofrequency

目的探讨丘脑Vim核中神经细胞的电活动与特发性震颤(ET)的关系,总结Vim核射频毁损(切开)术治疗ET的可行性、并发症及疗效。方法对72例ET行CT定位微电极导向Vim核射频,并进行FAHN评分。结果 Vim核中存在与肢体震颤节律一致的细胞电活动,毁损这些细胞后震颤立即消失,有效率100%。整体评分改善率60.2%;震颤程度和部位改善率53.1%;特殊动作和功能改善率51.6%;功能残疾改善率76.2%。暂时性并发症19例,3～36个月随访疗效稳定。结论丘脑Vim核中存在与ET密切相关的细胞,射频毁损Vim核是治疗ET安全有效措施。

Objective To explore the relationship between electrical activity of nerve cells in thalamus＇Vim nucleus and essential tremor（ ET）, evaluate feasibility , effectiveness and complication of radiofrequency ablation for ET. Methods Seventy - two patients with ET were scanned position by CT, microelectrode-guided Vim nucleus were ablated by radiofrequency and scored by FAHN. Results There were cell electrical activity with the same limb tremor rhythm in Vim nucleus , the tremors disappeared immediately after those cells impaired, the effective rate was 100%, overall rating improvement rate was 60.2%, tremor levels and area improvement rate were 53.1%, special action and function improvement rate were 51.6% and functional disability improvement rate was 76.2%. Temporary complication was found in 19 cases, therapeutic effect was stabilized during the following up from 3 to 36 months. Conclusion There was closely related cell with ET in thalamus Vim nucleus, radiofrequency ablation of Vim nucleus technique is a safe and effective method for ET.