Combination of Thalamotomy and Longitudinal Myelotomy in the Treatment of Multiple Sclerosis

Laitinen, Lauri V.; A, Arsalo; Hänninen, Asko

doi:10.1007/978-3-7091-8355-7_12

Cited by 1 publication

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“…[59][60][61][62] Speelman and van Manen 63 proposed a tremor rating scale for severity of arm intention tremor, which was used in a later study by another group. 64 Of the remaining studies, three were case studies, [65][66][67] three compared thalamotomy and DBS, [68][69][70] and one included the use of magnetic resonance imaging (MRI)-and computed tomography-guided thalamotomy. 71 In general, studies showed tremor improvement after surgery; however, outcome measures were varied because there was no standard evaluation method.…”

Section: Thalamotomymentioning

confidence: 99%

Upper Limb Intention Tremor in Multiple Sclerosis

McCreary¹,

Rogers²,

Forwell³

2018

International Journal of MS Care

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Background: To present the current knowledge on the characteristics, assessment, and treatment of upper limb intention tremor to inform and improve future intervention studies in patients with multiple sclerosis (MS), we conducted a literature review for articles on upper limb intention tremor in patients with MS. Methods: Two reviewers conducted searches in PubMed, Web of Science, and MEDLINE (Ovid). Relevant articles, sorted on inclusion criteria, were examined for descriptions and assessments of upper limb intention tremor, and intervention studies were evaluated based on treatment type. Results: Eight descriptive studies were found reporting on the incidence and severity of tremor, impairments, and lesion load. Ten studies focused on measurement of tremor using various assessments. Intervention studies included eight articles using a diverse set of noninvasive techniques mainly showing transient reduction in tremor amplitude and temporary increase in function. Eighteen studies on pharmacologic interventions were found, with most displaying positive outcomes and mediation of tremor; others showed little to no benefit. Surgical interventions included 17 studies on thalamotomy and 20 on deep brain stimulation. Most studies showed tremor improvement after surgery; however, most sample sizes were small, and interventions were highly invasive, with potential adverse effects resulting from surgery. Conclusions: The literature on upper limb intention tremor in MS is relatively sparse. More studies are required to determine mechanism of action and to provide more suitable and sustainable interventions to decrease upper limb intention tremor and improve quality of life of individuals with MS.

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