Skip to content

    Brain & Nervous System Health Center

    Font Size

    Understanding Surgery for Essential Tremor



    Thalamotomy is a surgery for essential tremor that destroys a small part of a structure in the brain called the thalamus. Surgeons typically perform this procedure on only one side of the brain because surgery on both sides of the brain increases the risk for potential complications. The procedure provides relief to the opposite side of the body. So, if the right side of the brain is operated on, the person will experience tremor relief on the left side of his body. Approximately 80% of patients who have this procedure experience relief from their tremors.

    Common, but temporary, side effects of thalamotomy include:

    • Confusion
    • Weakness
    • Disturbed speech
    • Balance problems

    The major disadvantage of thalamotomy is the permanent destruction of this area of the brain, which may limit future treatment options, and thalamotomy should only be performed under rare circumstances. Deep brain stimulation, described below, is safer and more effective.

    Deep Brain Stimulation
    Also called "thalamic stimulation," deep brain stimulation is a way to inactivate the thalamus without destroying a part of the brain. The risks are, therefore, much less than with thalamotomy. Rather than destroying brain tissue, deep brain stimulation achieves the same effects using small electrical shocks.

    The electrode for deep brain stimulation is left in the brain and connected by a wire to a pacemaker-like device implanted under the skin of the chest. The pacemaker-like device generates the tiny electrical impulses that aren't painful to the patient. These shocks alter electrical "messages" going through the thalamus. Deep brain stimulation provides moderate relief for approximately 90% of patients.

    Advantages of deep brain stimulation include:

    • It doesn't destroy brain tissue and won't limit future treatment.
    • The device can be removed at any time.
    • It is adjustable.
    • It may be more effective in controlling tremors than thalamotomy.

    Disadvantages of deep brain stimulation include:

    • The presence of a foreign object in the body, increasing the risk of infection.
    • A battery in the device that must be replaced every three to five years.
    • Uncomfortable sensations that may occur during stimulation.

    As with any surgery, there are potential risks associated with these forms of treatment for essential tremor. Talk with your doctor about these risks and any other potential complications.

    WebMD Medical Reference

    Reviewed by Neil Lava, MD on October 11, 2014

    Today on WebMD

    nerve damage
    Learn how this disease affects the nervous system.
    senior woman with lost expression
    Know the early warning signs.
    woman in art gallery
    Tips to stay smart, sharp, and focused.
    medical marijuana plant
    What is it used for?
    woman embracing dog
    boy hits soccer ball with head
    red and white swirl
    marijuana plant
    brain illustration stroke
    nerve damage
    Alzheimers Overview
    Graphic of number filled head and dna double helix