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What is a Thalamotomy?

  • Thalamotomy is a type of brain surgery in which the thalamus, a tiny area of the brain, is destroyed.
  • Before surgery, detailed brain scans using a CT scan or MRI are done to identify the precise location for treatment.
  • Surgery on one side of the brain affects the opposite side of the body. If you have tremor in your right hand, for instance, the left side of your brain will be treated.
  • The procedure can be repeated on the other side of the brain if needed, but it greatly increases the risk of speech and cognitive problems after surgery.
  • Thalamotomy usually is reserved for people younger than 65 who have normal intellectual function and normal recent memory.

How is the surgery performed?

  • During the surgery, the patient is awake, but the scalp area where instruments are inserted is numbed with a local anesthetic.
  • The surgeon inserts a hollow probe through a small hole drilled in the skull to the target location.
  • An extremely cold substance, liquid nitrogen, is circulated inside the probe. The cold probe destroys the targeted brain tissue.
  • The probe is then removed, and the wound is closed.

What can you expect after surgery?

The surgery usually requires a 2-day hospital stay. Most people recover completely within about 6 weeks. It is best to discuss the risks associated with your neurologist because there are many risk factors, including underlying medical conditions.

How often are they performed?

  • Thalamotomy is rarely done today.
  • It may be used to treat severe tremor on one side of the body (most often in an arm or leg) that does not respond to medications. It does not help with slow movement (bradykinesia), speech problems, or walking difficulties.

Page reviewed by Dr. Joash Lazarus, NPF Movement Disorders Fellow, Department of Neurology at Emory University School of Medicine.

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