gms | German Medical Science

55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

Long-term outcome of MS-Tremor after VIM-Stimulation

Langzeitverlauf bei MS-Tremor nach VIM-Stimulation

Meeting Abstract

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  • corresponding author Jan H. Mehrkens - Neurochirurgische Universitätsklinik, Klinikum Großhadern der Ludwig-Maximilians-Universität, München
  • U. Steude - Neurochirurgische Universitätsklinik, Klinikum Großhadern der Ludwig-Maximilians-Universität, München
  • K. Bötzel - Neurologische Universitätsklinik, Klinikum Großhadern der Ludwig-Maximilians-Universität, München

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocDI.06.04

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2004/04dgnc0205.shtml

Veröffentlicht: 23. April 2004

© 2004 Mehrkens et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

Tremor in patients with multiple sclerosis (MS) is more difficult to treat with VIM (nucleus ventero-intermedius) deep brain stimulation (DBS) than essential or parkinsonian tremor. We retrospectively analyzed short-term success and long-term outcome in our series of MS patients who received VIM stimulation and discuss strategies for the prediction of a good functional outcome.

Methods

Fourteen MS patients (8 female, 6 male, mean age 41 years, all chronic progressive course of the disease) were operated on between 1997 and 2002. Patients were eligible for surgery when a disabling postural or intention tremor of one or both upper extremities was present. Exclusion criteria were midbrain tremor, grossly impaired sensory or motor functions of the hands and major cognitive deficits. Functional outcome was assessed with a standardized questionnaire and tremor-reduction was measured with a motion-tracking device.

Results

Five patients received bilateral and five patients unilateral implantations. Four patients received no implantation because of unsuccessful test stimulation. In 5 patients, the tremor was stopped completely, in the remaining a marked reduction was observed. Functional outcome showed an improvement of over 60% in all patients postoperatively. Only 30% of patients who received electrodes had a sustained improvement lasting longer than 2 years. These patients had minimal progression of the underlying disease. All patients who underwent DBS for their MS-induced tremor would undergo the procedure again.

Conclusions

We conclude from our data that DBS of the VIM is effective in selected patients with MS-tremor. Long-term success is limited due to progressiveness of the underlying disease. Severity of the initial symptoms and the rate of the disease progression might be predictors for an unfavorable long-term outcome.