gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

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Thalamic deep brain stimulation in patients with tremor due to multiple sclerosis

Meeting Abstract

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  • G. Lütjens - Neurochirurgische Klinik, Medizinische Hochschule Hannover, Deutschland
  • C. Schrader - Neurologische Klinik, Medizinische Hochschule Hannover, Deutschland
  • C. Blahak - Neurologische Klinik, Universitätsklinikum Mannheim, Deutschland
  • H. Bäzner - Neurologische Klinik, Universitätsklinikum Mannheim, Deutschland
  • R. Dengler - Neurologische Klinik, Medizinische Hochschule Hannover, Deutschland
  • J.K. Krauss - Neurochirurgische Klinik, Medizinische Hochschule Hannover, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocFR.10.07

doi: 10.3205/12dgnc250, urn:nbn:de:0183-12dgnc2507

Published: June 4, 2012

© 2012 Lütjens et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: To evaluate the long-term effect of thalamic deep brain stimulation (DBS) in a series of patients with severe tremor due to multiple sclerosis. DBS of the thalamic VIM has been shown to improve tremor in patients suffering from various tremor disorders. The issue of DBS in patients with tremor due to multiple sclerosis has been a matter of debate. Kinetic and postural tremors in multiple sclerosis may result in considerable functional impairment. Since tremor is only one of many symptoms in multiple sclerosis patients, the impact of thalamic DBS on overall disability remains unclear.

Methods: We evaluated the results of thalamic DBS on long-term outcome in a series of 11 patients. Mean age was 57 years (range, 31–75, 6 F / 5 M). All patients had a chronic progressive course of multiple sclerosis. Tremor was disabling in all instances. CT-stereotactic implantation of 3387 electrodes in the Vim was performed without surgical complications in all patients. In 9 patients the electrode was on the right side, in 2 patients on the left.

Results: All patients were available for long-term follow-up. Initial symptomatic improvement was present in all instances. This, however, did not correlate with functional improvement. Both symptomatic and functional long-term improvement was found only in single instances. Energy delivery was higher on the average than in other tremor disorders. In particular, patients with cognitive impairment did not benefit from thalamic DBS.

Conclusions: Thalamic DBS is a safe and modifiable treatment option for patient with severe disabling tremor due to multiple sclerosis. Nevertheless, patient selection remains a challenging task in this type of tremor.