Improvement of severe postural cerebellar tremor in multiple sclerosis by chronic thalamic stimulation
Identifieur interne : 000600 ( France/Analysis ); précédent : 000599; suivant : 000601Improvement of severe postural cerebellar tremor in multiple sclerosis by chronic thalamic stimulation
Auteurs : C. Geny ; Nguyen ; B. Pollin [France] ; A. Feve ; F. Ricolfi ; P. Cesaro ; J. DegosSource :
- Movement Disorders [ 0885-3185 ] ; 1996-09.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Homme.
English descriptors
- KwdEn :
- Adult, Brain (vertebrata), Cerebellum (physiopathology), Electric, Electric Stimulation, Electrical stimulation, Electrodes, Implanted, Female, Human, Humans, Male, Middle Aged, Multiple Sclerosis (complications), Multiple sclerosis, Postural tremor, Posture, Stereotaxia, Stereotaxic Techniques, Stereotaxy, Stimulation, Thalamus, Thalamus (surgery), Treatment Outcome, Treatment efficiency, Tremor, Tremor (complications), Tremor (physiopathology), Tremor (therapy).
- MESH :
- complications : Multiple Sclerosis, Tremor.
- physiopathology : Cerebellum, Tremor.
- surgery : Thalamus.
- therapy : Tremor.
- Adult, Electric Stimulation, Electrodes, Implanted, Female, Humans, Male, Middle Aged, Posture, Stereotaxic Techniques, Treatment Outcome.
Abstract
Tremor can be particularly disabling in patients with multiple sclerosis (MS) and is mildly improved by drug treatment. The efficiency of stereotactic thalamotomy has been reported in a small number of patients but was counterbalanced by severe postoperative complications. Stimulation of the thalamic ventral intermediate nucleus, which is a less aggressive surgical method, is efficient in essential and in parkinsonian tremors. We report here the results of thalamic stimulation in 13 patients with MS with tremor. All patients were subjected to clinical examination, videorecording, and quantification of the functional disability before surgery and 3 months postoperatively. The surgical intervention was well tolerated in all cases. A clear improvement of the tremor was observed in 69.2% of the patients. Functional improvement was more varied and depended on the severity of tremor and coexistence of other neurological symptoms. Of the eight most severely affected patients, seven recovered the possibility to easily catch an object and use it. The results indicate that thalamic stimulation may be useful in the treatment of severe postural cerebellar tremor in MS.
Url:
DOI: 10.1002/mds.870110503
Affiliations:
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ISTEX:06C95C0C43FCA698622B6B81C8C4C5E7DF62BAABLe document en format XML
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Feve</name><affiliation><wicri:noCountry code="subField">Créteil</wicri:noCountry></affiliation></author><author><name sortKey="Ricolfi, F" sort="Ricolfi, F" uniqKey="Ricolfi F" first="F." last="Ricolfi">F. Ricolfi</name><affiliation><wicri:noCountry code="subField">Créteil</wicri:noCountry></affiliation></author><author><name sortKey="Cesaro, P" sort="Cesaro, P" uniqKey="Cesaro P" first="P." last="Cesaro">P. Cesaro</name><affiliation><wicri:noCountry code="subField">Créteil</wicri:noCountry></affiliation><affiliation><wicri:noCountry code="subField">Créteil</wicri:noCountry></affiliation></author><author><name sortKey="Degos, J" sort="Degos, J" uniqKey="Degos J" first="J." last="Degos">J. Degos</name><affiliation><wicri:noCountry code="subField">Créteil</wicri:noCountry></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="sub">Official Journal of the Movement Disorder Society</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="1996-09">1996-09</date><biblScope unit="vol">11</biblScope><biblScope unit="issue">5</biblScope><biblScope unit="page" from="489">489</biblScope><biblScope unit="page" to="494">494</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">06C95C0C43FCA698622B6B81C8C4C5E7DF62BAAB</idno><idno type="DOI">10.1002/mds.870110503</idno><idno type="ArticleID">MDS870110503</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Brain (vertebrata)</term><term>Cerebellum (physiopathology)</term><term>Electric</term><term>Electric Stimulation</term><term>Electrical stimulation</term><term>Electrodes, Implanted</term><term>Female</term><term>Human</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Multiple Sclerosis (complications)</term><term>Multiple sclerosis</term><term>Postural tremor</term><term>Posture</term><term>Stereotaxia</term><term>Stereotaxic Techniques</term><term>Stereotaxy</term><term>Stimulation</term><term>Thalamus</term><term>Thalamus (surgery)</term><term>Treatment Outcome</term><term>Treatment efficiency</term><term>Tremor</term><term>Tremor (complications)</term><term>Tremor (physiopathology)</term><term>Tremor (therapy)</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Multiple Sclerosis</term><term>Tremor</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Cerebellum</term><term>Tremor</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Thalamus</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Tremor</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Electric Stimulation</term><term>Electrodes, Implanted</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Posture</term><term>Stereotaxic Techniques</term><term>Treatment Outcome</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Efficacité traitement</term><term>Electrique</term><term>Encéphale</term><term>Homme</term><term>Posture</term><term>Sclérose en plaque</term><term>Stimulation</term><term>Stéréotaxie</term><term>Thalamus</term><term>Tremblement</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Tremor can be particularly disabling in patients with multiple sclerosis (MS) and is mildly improved by drug treatment. The efficiency of stereotactic thalamotomy has been reported in a small number of patients but was counterbalanced by severe postoperative complications. Stimulation of the thalamic ventral intermediate nucleus, which is a less aggressive surgical method, is efficient in essential and in parkinsonian tremors. We report here the results of thalamic stimulation in 13 patients with MS with tremor. All patients were subjected to clinical examination, videorecording, and quantification of the functional disability before surgery and 3 months postoperatively. The surgical intervention was well tolerated in all cases. A clear improvement of the tremor was observed in 69.2% of the patients. Functional improvement was more varied and depended on the severity of tremor and coexistence of other neurological symptoms. Of the eight most severely affected patients, seven recovered the possibility to easily catch an object and use it. The results indicate that thalamic stimulation may be useful in the treatment of severe postural cerebellar tremor in MS.</div></front></TEI><affiliations><list><country><li>France</li></country><settlement><li>Paris</li></settlement></list><tree><noCountry><name sortKey="Cesaro, P" sort="Cesaro, P" uniqKey="Cesaro P" first="P." last="Cesaro">P. Cesaro</name><name sortKey="Degos, J" sort="Degos, J" uniqKey="Degos J" first="J." last="Degos">J. Degos</name><name sortKey="Feve, A" sort="Feve, A" uniqKey="Feve A" first="A." last="Feve">A. Feve</name><name sortKey="Geny, C" sort="Geny, C" uniqKey="Geny C" first="C." last="Geny">C. Geny</name><name sortKey="Nguyen" sort="Nguyen" uniqKey="Nguyen" last="Nguyen">Nguyen</name><name sortKey="Ricolfi, F" sort="Ricolfi, F" uniqKey="Ricolfi F" first="F." last="Ricolfi">F. Ricolfi</name></noCountry><country name="France"><noRegion><name sortKey="Pollin, B" sort="Pollin, B" uniqKey="Pollin B" first="B." last="Pollin">B. 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