Accelerometry during ablative thalamic surgery for parkinsonian tremor.

J. Ciurea V. Nestianu*, Ileana Simoca, Dept. of Neurosurgery, University Hospital “ Bagdasar Arseni”, Bucharest, Romania; * Dept. of Neurophysiology, University of Medicine Craiova, Romania.
E-mail: ciureaj@yahoo.com

 

We conceived, designed and constructed a “home-made” accelerometer and used it to assess tremor in patients during thalamotomy. Our series included 8 patients: 3 women and 5 men, with an age range of 32 to 68 years with a mean of 52 years. The three parameters: frequency (Hz), amplitude, and occurrence of tremor were studied during electrical stimulation of the target and compared with neurological direct observation. The optimal lesion site was taken to be where the tremor was suppressed with the lowest electrical stimulation. These results demonstrated an earlier reaction of the accelerometer system at lower stimulation thresholds when compared to direct observation of a trained neurologist. Intraoperative accelerometer monitoring provides an adjunct to improve reliability of assessment of target stimulation while documenting lesion effects, supporting the neurologist and not replacing her and not affecting the duration of surgery.

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