TY - JOUR
T1 - Surgical therapy for multiple sclerosis tremor
T2 - A 12-year follow-up study
AU - Hassan, A.
AU - Ahlskog, J. E.
AU - Rodriguez, M.
AU - Matsumoto, J. Y.
PY - 2012/5
Y1 - 2012/5
N2 - Background and purpose: Severe multiple sclerosis (MS) tremor causes disability poorly responsive to medication. Deep brain stimulation (DBS) or thalamotomy can suppress tremor, but long-term outcomes are unclear. Methods: Nine patients with MS tremor underwent disability measures at baseline and 12months post-surgery (six thalamotomy, three DBS) in 1997-1998 (previously reported, Matsumoto et al., Neurology 2001;57:1876-82). We report the prospective 12-year follow-up of this cohort for tremor, disability, and death. Results: Surgery was initially successful in all. Tremor recurred in all patients within median 3months, although two DBS patients were tremor-free for 5years. Median tremor-free survival (tremor-free time/survival time) was 4.3%. At 12-year follow-up, four survivors (two thalamotomy, two DBS) (Expanded Disability Status Scale scores 8-8.5) were severely disabled. Five patients were dead (four thalamotomy, one DBS) median 5.8years post-operative. Conclusions: Surgery benefit for severe tremor was overall short-lived (median 3months), with long-term poor prognosis. Although two DBS patients had sustained 5-year tremor-suppression, the observed progressive disability and death in this cohort bear importance for long-term success in future MS tremor surgery trials.
AB - Background and purpose: Severe multiple sclerosis (MS) tremor causes disability poorly responsive to medication. Deep brain stimulation (DBS) or thalamotomy can suppress tremor, but long-term outcomes are unclear. Methods: Nine patients with MS tremor underwent disability measures at baseline and 12months post-surgery (six thalamotomy, three DBS) in 1997-1998 (previously reported, Matsumoto et al., Neurology 2001;57:1876-82). We report the prospective 12-year follow-up of this cohort for tremor, disability, and death. Results: Surgery was initially successful in all. Tremor recurred in all patients within median 3months, although two DBS patients were tremor-free for 5years. Median tremor-free survival (tremor-free time/survival time) was 4.3%. At 12-year follow-up, four survivors (two thalamotomy, two DBS) (Expanded Disability Status Scale scores 8-8.5) were severely disabled. Five patients were dead (four thalamotomy, one DBS) median 5.8years post-operative. Conclusions: Surgery benefit for severe tremor was overall short-lived (median 3months), with long-term poor prognosis. Although two DBS patients had sustained 5-year tremor-suppression, the observed progressive disability and death in this cohort bear importance for long-term success in future MS tremor surgery trials.
KW - Deep brain stimulation
KW - Multiple sclerosis
KW - Surgery
KW - Thalamotomy
KW - Tremor
UR - http://www.scopus.com/inward/record.url?scp=84859850262&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84859850262&partnerID=8YFLogxK
U2 - 10.1111/j.1468-1331.2011.03626.x
DO - 10.1111/j.1468-1331.2011.03626.x
M3 - Article
C2 - 22248187
AN - SCOPUS:84859850262
SN - 1351-5101
VL - 19
SP - 764
EP - 768
JO - European Journal of Neurology
JF - European Journal of Neurology
IS - 5
ER -