Neuromodulation in Turkey · Istanbul
Head tremor treatment and deep brain stimulation
Head tremor can be treated. Most people start with medication or injections into the neck muscles; when these are not enough, deep brain stimulation (DBS) can reduce the shaking substantially. Prof. Atilla YILMAZ, MD treats head tremor with a double-target DBS technique published in Stereotactic and Functional Neurosurgery.
Head tremor is an involuntary, rhythmic shaking of the head — side to side (“no-no”), up and down (“yes-yes”) or a mixture. It is most often caused by essential tremor or dystonia, and less often by multiple sclerosis, a brain injury or a stroke. Treatment depends on the cause: medication and botulinum toxin injections help some people, and deep brain stimulation (DBS) is the most effective option when they do not [1],[2].
HeadTremor.com is written and medically reviewed by Prof. Atilla YILMAZ, MD, a stereotactic and functional neurosurgeon who has performed 1,200+ neuromodulation procedures, including 800+ DBS surgeries, for patients from 60+ countries. In Prof. YILMAZ’s peer-reviewed series of 22 patients with rare tremor syndromes treated with double-target Vim+PSA DBS, the mean tremor reduction was 89% (range 50–100%), and 6 of 7 patients with isolated head tremor had a tremor score of 0 at 12 months, as rated blindly by two movement disorder specialists [3].
Meet your surgeon
Prof. Atilla YILMAZ, MD
Prof. YILMAZ is a stereotactic and functional neurosurgeon whose practice is devoted to deep brain stimulation. He has performed 1,200+ neuromodulation procedures, including 800+ DBS surgeries, for patients from 60+ countries, and he personally reviews every case, decides on every operation and performs every surgery himself.
- Author of the technique: first author of the 2024 double-target Vim+PSA series in Stereotactic and Functional Neurosurgery, written with Prof. Patric Blomstedt of Umeå University, Sweden [3]
- Leader in his field: President of the Middle-Eastern Society for Stereotactic and Functional Neurosurgery (MSSFN); Board of Directors of the World Society for Stereotactic and Functional Neurosurgery and of the International Neuromodulation Society; Executive Committee of the European Society (ESSFN)
- Teacher of surgeons: Medtronic, Abbott and Boston Scientific appoint him as a proctor to train other neurosurgeons on their DBS systems; 40+ fellows trained from 30 countries; Workshop Director at the 2025 World Congress of Neurosurgery in Dubai
- Pioneer: performed the first-ever DBS surgeries in Bosnia, Libya, Algeria, Jordan, Kazakhstan and Pakistan
- Researcher: 43 international peer-reviewed articles; invited reviewer for Stereotactic and Functional Neurosurgery, Neuromodulation and World Neurosurgery; Golden Medal Award, MSSFN 2022
Start with your question
What is head tremor?
How it looks, why it happens and when it needs treatment.
How is head tremor treated?
Every option, step by step, with what each can and cannot do.
Can DBS stop head tremor?
Targets, the operation, results and risks.
What does the evidence say?
Published studies, including those that report limited benefit.
See patient results
Before-and-after videos shared with patients’ written consent.
Life after surgery
Stitches, showering, hair, scars and returning to normal life.
Types of head tremor
Recognizing the type of tremor matters, because it decides which treatment — and which DBS target — is most likely to work.
Essential head tremor
Rhythmic “no-no” or “yes-yes” shaking, usually with hand tremor.
Dystonic head tremor
Jerky, irregular shaking with neck pulling or a tilted head.
Isolated head tremor
Head shaking with no tremor anywhere else in the body.
Holmes tremor
Slow, coarse tremor appearing months after a brain injury or stroke.
Secondary head tremor
Caused by multiple sclerosis, trauma, stroke or other conditions.
Parkinson’s and head tremor
Why true head tremor is uncommon in Parkinson’s disease.
What happens when DBS works
At our center the stimulator is switched on the day after surgery. After a successful operation, head tremor usually stops almost as soon as stimulation begins; some centers wait about two weeks before the first switch-on. Each contact on the electrodes, in both the Vim and the PSA, is tested one by one, and the stimulator is set on the contact that gives the most benefit with the fewest side effects. Our longest-followed head tremor patient still has a tremor score of 0 six and a half years after double-target DBS; the score was 4 before surgery (our case series; results vary).
Play video: 40 Years of Head Tremor, 3 Years After DBS: Lasting Relief
Open the head tremor video library on this site.
Why patients travel to Istanbul for head tremor surgery
- A published technique for difficult tremors. The double-target approach stimulates the ventral intermediate nucleus of the thalamus (Vim) and the posterior subthalamic area (PSA), two parts of the tremor circuit, along one electrode path [3].
- Both sides treated. Head tremor is a midline symptom, so we operate on both sides of the brain, which also protects against the tremor spreading over time.
- Precise electrode placement. High-resolution 3 Tesla MRI under general anesthesia for planning, then microelectrode recording and test stimulation with the patient awake.
- Switch-on the next day. Programming begins the day after surgery, so you see the effect before you leave Istanbul.
- Follow-up from home. Remote programming by secure video call is free for 3 to 5 years, depending on the package chosen; after that it remains available, without limit, for a fee.
- One surgeon, one team. Prof. YILMAZ makes every candidacy decision and performs every operation, supported by a 25-member team.
Published evidence from our center
Yilmaz A, Eray HA, Cakir M, Ceylan M, Blomstedt P. Deep Brain Stimulation with Double Targeting of the VIM and PSA for the Treatment of Rare Tremor Syndromes. Stereotactic and Functional Neurosurgery 2024;102:224–239.
- 22 patients treated between 2019 and 2023 with bilateral Vim+PSA DBS: 7 isolated head tremor, 4 dystonic tremor, 8 Holmes tremor, 2 voice tremor and 1 tremor caused by liver disease.
- Mean tremor score fell from 3.70 to 0.45 at 12 months; mean tremor reduction 89% (range 50–100%).
- 6 of 7 patients with isolated head tremor reached a tremor score of 0.
- Ratings were made blindly, with stimulation on and off, by two movement disorder specialists.
- To the authors’ knowledge, the largest published case series of double-target Vim+PSA DBS in rare tremor syndromes [3].
Read the article on PubMed (PMID 38934181) · How the double-target technique works
Frequently asked questions
Will my head tremor stop after surgery?
What is the best treatment for head tremor?
How do I find out whether DBS could help me?
Sources
- Mayo Clinic News Network. When to consider deep brain stimulation for essential tremor (2023). newsnetwork.mayoclinic.org/discussion/mayo-clinic-minute-when-to-consider-deep-brain-stimulation-for-essential-tremor/
- International Essential Tremor Foundation. Deep Brain Stimulation. essentialtremor.org/resource/deep-brain-stimulation/
- Yilmaz A, Eray HA, Cakir M, Ceylan M, Blomstedt P. Deep Brain Stimulation with Double Targeting of the VIM and PSA for the Treatment of Rare Tremor Syndromes. Stereotact Funct Neurosurg 2024;102:224–239. DOI 10.1159/000539162. pubmed.ncbi.nlm.nih.gov/38934181/
