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Deep Brain Stimulation for Essential Tremor

Medically reviewed by Susan Kerrigan, MD and Marianne Madsen on February 3, 2023
Additions/comments by Neurologist Steve Schadendorf, MD

Essential tremor is a condition in which malfunctioning neurons cause the patient to experience uncontrollable rhythmic shaking. It becomes more pronounced with time and is most commonly seen in patients over 40 years of age. Although not considered dangerous, it can cause serious fine motor impairment and significantly reduce the quality of life for patients. 


One of the treatments that has been developed for this condition is known as deep brain stimulation. Because the brain works on electrical impulses, doctors can use a small battery pack and a wire implanted into the brain to send electrical signals that will attempt to help the brain behave normally. Here is what you need to know about this procedure. 


Should I consider deep brain stimulation? 


Patients should consult with a Neurologist and/or Neurosurgeon well versed in this treatment option in order to decide whether or not they are suitable for this procedure. As a general guideline, the patient should be someone with particularly severe symptoms who has already tried noninvasive therapy, such as medication, and found it to be ineffective. 


What happens during the procedure? 


Two main components will be implanted. The first is a device containing a computer and battery similar to a cardiac pacemaker, which will be implanted under the skin on the chest. Second, electrode wires will run under the skin of the neck and into the brain to deliver electrical impulses which override the abnormal signals causing tremor 


Once the patient has recovered from the surgery, the device will be activated using a specialized remote control. Doctors will test different settings to see which of them yield optimal performance. Once these are set, the patient will be given a simplified remote control to alter some settings on their specific device. 


Living with a deep brain implant


Having an implant may mean significant lifestyle changes, including modifying your physical activities, and occasional secondary procedures to replace the battery or resettle the implanted components should they be knocked out of position. Patients may need to be careful about swimming and going through security checks and should take care to avoid stress in the area in which the implant is located. Ask your doctor for specific instructions as to how you may need to alter your lifestyle and for a letter certifying that you have an implanted device should you need to pass through a metal detector. 


Is this Parkinson’s disease? 


Parkinson’s can present with a tremor but manifests in much different ways and requires different treatment. Some of the most notable differences between essential tremor and Parkinson’s disease are the motor symptoms of shuffling gait and instability, whereas essential tremor only manifests with limb or head shaking.  In addition, Parkinson’s disease involves the death of brain tissue while essential tremor is a malfunction of brain impulses, similar to a “short circuit.” However, both can be effectively treated with deep brain stimulation when other treatments such as medication are no longer sufficient. 




Deep brain stimulation is a procedure that requires a qualified and reputable surgical team which can have a significant positive impact on patients with essential tremor.

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