Patient C's experience of stereotactic thalamotomy
Patient C tells us about their experience of stereotactic
thalamotomy. This is a lesioning
technique - a form of surgery used to treat some of the
symptoms of Parkinson's.
The person's name has been withheld to protect
confidentiality.
Operation noted for relieving tremor
30 days after the operation my hand was still tremor free, apart from the occasional slow shake. I would say it is an 80% improvement.
"I was diagnosed with Parkinson's when I was 54. My main symptom
was tremor, which badly affected my right hand and arm.
"I tried all the usual drugs but none seemed to bring about any
improvement.
"My consultant suggested an operation known as stereotactic
thalamotomy, noted for relieving tremor.
"At the appointment with the neurosurgeon, I was told that my
operation would be on the left side of the brain, the opposite side
to the tremor.
"The operation carried a small risk of my speech being affected,
as well as slight weakness or clumsiness of the limbs, which, if it
occurs, is usually temporary.
"The greatest risk was that the procedure might not relieve the
tremor.
First part of the operation
"I was admitted to hospital 14 months later. The first day was
taken up with a thorough medical examination, temperature and blood
pressure, weight, heart scan and hundreds of questions.
"The first part of the operation took place the next day.
"I was given a general anaesthetic and a small hole was made
through the bone of my skull, where the electrode was to be
inserted the next day.
"They shaved a patch of hair about 2 to 3 inches near the top of
my head.
"I had to have about 6 stitches but a dressing covered them for
the first few days.
"Being a Muslim woman, who normally wears Muslim dress (long
coat or dress with long sleeves and a headscarf), I had asked to be
kept covered up as much as possible.
"When I came round from the operation, my scarf was neatly
folded on my pillow. My Muslim modesty had been taken into account
by covering my head with a dressing 'hat'.
Second part of the operation
"The next day I was taken to the operating theatre fully
conscious. This was partly so that any adverse reaction to the
electrode could be observed and also to observe the tremor, which
would be non-existent under general anaesthetic.
"Firstly, they took a couple of X-rays, one from the back of my
head and one from the front.
"Information from these X-rays enables the computer to work out
where the electrode is to be positioned.
"In order to guide the electrode to the target site in the
thalamus, a metal stereotactic frame was attached to my head.
"I was given 4 local anaesthetics, 2 in my forehead and 2 at the
back.
"After they had taken effect, the surgeon screwed the frame on
firmly.
"He then told me that I would feel something cold as he threaded
the electrode between the stitches and into the hole. Then he sat
down at the computer, which I could not see.
"Fortunately the brain does not feel pain and I was completely
unaware of the electrode's passage through my head.
"I was instructed to report any strange sensation and suddenly I
felt my nose and mouth twitching like a rabbit!
"The surgeon remarked that it showed we were on the right track.
A few seconds later he announced that he had reached the target and
I saw that my hand had stopped shaking.
"He said that if he now removed the electrode, the tremor would
shortly resume.
"To prevent this, he needed to heat the electrode gently until
it reached the correct temperature and maintain it at that heat for
about 90 seconds.
"After this the procedure was complete. The electrode and metal
frame were removed – and it was over!
"I went straight back to the ward, very relieved it was over and
with no tremor. I was extremely tired over the next few days.
"My legs felt odd – very heavy and clumsy, the right one in
particular. I remembered this could be a temporary side effect.
80% improvement
"I left hospital after a week and was referred to a local health
centre for physiotherapy. I kept bumping into doors, as my legs did
not seem to go where I put them.
"But gradually things improved as I regained control. I was
easily tired and needed frequent rests.
"30 days after the operation my hand was still tremor free,
apart from the occasional slow shake, but nothing like as severe as
it was. I would say it is an 80% improvement.
"I am still working on getting my leg as normal as possible but
my arm has regained its swing."
More surgery stories
You can read more on surgery for Parkinson's in our Surgery and Parkinson's booklet
The main forms of surgery for Parkinson's
Return to the surgical treatments of
Parkinson's main page
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