Artikel
Deep brain stimulation of the VIM for tremor in multiple sclerosis
Tiefe Hirnstimulation des VIM bei MS-Tremor Patienten
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Autoren
Veröffentlicht: | 4. Mai 2005 |
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Gliederung
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Objective
We report on our experiences with deep brain stimulation of the VIM for disabling tremor in patients with multiple sclerosis.
Methods
Ten patients with multiple sclerosis (mostly chronic progressive course) underwent implantation of DBS electrodes into the VIM from 2001 to 2004. In all cases intraoperative microelectrode recording and macrostimulation was performed under local anaesthesia before permanent implantation.
Results
Implantation was bilateral in five patients and unilateral also in five patients. The Fahn Tremor score preoperatively was in mean 74, 46 at 3-months and 51 at 12-months. In those patients with a longer follow-up (up to 36 months) there was no clinical deterioration up to now. According to results of macrostimulation and microelectrode recording the most permanent electrodes were implanted on the medial trajectory (n=11) and the central trajectory (n=4). Best stimulation effects were on the two lower contacts, i.e. in the medio-caudal portion of the VIM. There was one intracerebral haemorrhage with a transient hemiparesis, which resolved completely after three months.
Conclusions
Thalamic stimulation significantly reduced tremor associated with MS and improved the hand function of the targeted upper limb. The best stimulation results were achieved on the lowest two contacts of the medial and, less frequently, of the central trajectory.