Treatment of myoclonic dystonia with transcutaneous electrical nerve stimulation

Abstract

The use of a transcutaneous nerve stimulator yielded positive results in a condition marked by involuntary movements (tremors and myoclonias) and dystonia. In the absence of clues to the pathophysiology of the myoclonus and dystonia, it is argued that transcutaneous stimulation induces an action on the neurotransmitters that inhibits neuromuscular function.

The effect of long‐term TENS on persistent neuroplastic changes in the human cerebral cortex

“…Electrical nerve stimulation in general, and transcutaneous electrical nerve stimulation (TENS) in particular have been applied successfully in neurorehabilitation, such as in the treatment of stroke [Levin and Hui-Chan, 1992;Ng and Hui-Chan, 2007;Sonde et al, 1998], urinary symptoms [Skeil and Thorpe, 2001], spinal cord injury [Fung and Barbeau, 1994;Goulet et al, 1996], multiple sclerosis [Armutlu et al, 2003;Miller et al, 2007], writer's cramp [Tinazzi et al, 2006] and/or to reduce movement disorders caused by tremor, myoclonia, or dystonia [Bending and Cleeves, 1990;Foley-Nolan et al, 1990;Toglia and Izzo, 1985]. This body of literature suggests that daily training with TENS may effectively activate larger parts of the underlying distributed sensorimotor networks of the brain.…”

Etiological and therapeutical observations in a case of belly dancer's dyskinesia

“…Its mechanism of action is not known. The use of TENS has been reported to be effective in myoclonic dystonia and tremor,4 although this finding has been disputed recently 5. We report on a woman with belly dancer's syndrome probably induced by clebopride and a striking response to the application of TENS.…”

Acute effect of transcutaneous electrical nerve stimulation on tremor

“…It is also possible that frequency could have been a factor limiting the efficacy of the stimulation procedures presented here. However, we evaluated the maximum stimulation frequency permitted by the TENS device used (100 Hz), and because the rates used for the treatment of pain generally range from 60 to 100 Hz and 3 to 80 Hz has been reported to be effective for movement disorders3 (J. Toglia, personal communication, 2001), we believe it is unlikely that the use of higher stimulation frequencies would have provided significantly greater clinical benefit than demonstrated in our study. Finally, TENS may require chronic application for beneficial effects, especially if it operates by changing levels of neurotransmitters within spinal chord or supraspinal pathways.…”

“…One electrode was placed over the brachial plexus at the inferior lateral corner of the posterior triangle of the neck bordered inferiorly by the clavicle and laterally by the trapezius. The other electrode was placed over the C7 spinous process (as described by Toglia and Izzo) 3. The brachial plexus electrode was initially used as the cathode in all patients.…”

“…Despite its widespread clinical use, the physiological mechanism of action is not known, stimulating parameters are subjective, electrode placement is empirical, and most of all, its effectiveness is a subject of controversy 2. Regardless of these uncertainties, the use of TENS has been reported to be effective in certain movement disorders, namely myoclonic dystonia3 and essential tremor (ET) (J. Toglia, personal communication, 2001). We evaluated, under subjective and objective parameters, the acute effects of TENS on tremor.…”