Deep Brain Stimulation for Essential Tremor

Essential tremor (ET) is one of the most common movement disorders and can result in disabling symptoms that are refractory to standard medications. In 1997, the US Food and Drug Administration approved deep brain stimulation (DBS) of the ventral intermedius nucleus of the thalamus for treatment of ET. DBS often reduces or eliminates the need for medications to treat ET. Proper patient selection and expertise in DBS programming are critical to ensure optimal outcomes. Recent advances in DBS include directional current steering and multisource independent constant current to program each electrode with its own power source. This chapter discusses proper patient selection, programming guidelines, and clinical pearls in DBS for ET.