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Neurology 1999;53:625
© 1999 American Academy of Neurology
Brief Communications

Chronic thalamic stimulation for the tremor of multiple sclerosis

Erwin B. Montgomery, Jr., MD, Kenneth B. Baker, PhD, R. Philip Kinkel, MD and Gene Barnett, MD

From the Department of Neurology (Drs. Montgomery, Baker, and Kinkel), Department of Neuroscience (Drs. Montgomery and Baker), Lerner Research Institute; Mellen Center for Multiple Sclerosis Treatment and Research (Dr. Kinkel); and Department of Neurosurgery (Dr. Barnett), Cleveland Clinic Foundation, Cleveland, OH.

Address correspondence and reprint requests to Dr. Erwin B. Montgomery, Jr., Department of Neurology, Desk S90, Cleveland Clinic Foundation, 9500 Euclid Ave., Cleveland, OH 44195.

The authors studied chronic high-frequency stimulation of the ventral intermediate nucleus of the thalamus (Vim) for controlling upper extremity tremor in patients with MS using MRI, CT, and microelectrode recordings and stimulation to locate optimal target sites. Fifteen patients underwent surgery. All patients had reduced tremor but developed tolerance requiring repeated programming of the stimulator. Benefit at optimal stimulator settings was maintained. Two patients experienced complications: intracerebral hematoma and MS exacerbation. Chronic high-frequency stimulation of Vim provides tremor reduction if patients have access to frequent stimulator adjustments. This surgery is relatively safe.




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