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[Tremor and abnormal movement in multiple sclerosis: symptomatic therapeutic indications]
F Viallet1, T Witjas, D Gayraud
1Service de Neurologie, CH du Pays d'Aix, Avenue des Tamaris, 13616 Aix-en-Provence.
Revue Neurologique
|January 15, 2002
Summary
Multiple sclerosis (MS) patients experience severe functional impairment due to tremors and movement disorders. Deep brain stimulation and carbamazepine offer potential therapeutic options for managing these debilitating symptoms.
Area of Science:
- Neurology
- Neuroscience
- Movement Disorders
Context:
- Multiple sclerosis (MS) frequently causes significant functional impairment through tremors and movement disorders.
- Specific tremors in MS include cerebellar, Holmes, and palatal tremors.
- Movement disorders like paroxysmal dyskinesias, dystonia, and parkinsonism are also observed in MS patients.
Purpose:
- To review the spectrum of tremor and movement disorders in multiple sclerosis.
- To discuss current and potential therapeutic interventions for these conditions.
Summary:
- Multiple sclerosis (MS) is associated with various tremors, including cerebellar tremor (intention-dominant), Holmes tremor (rest and postural components), and palatal tremor.
- Deep brain stimulation targeting the VIM thalamus can partially alleviate rest and postural tremor components, particularly in the proximal limbs, when medications are ineffective.
- Paroxysmal dyskinesias respond well to carbamazepine, while dystonia and parkinsonism can be coincidental features of MS.
Impact:
- Provides an overview of neurological complications in MS.
- Highlights advanced treatment options like deep brain stimulation for refractory tremors.
- Offers insights into pharmacotherapy for movement disorders in MS patients.