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Published on: December 13, 2017
Chronic spinal cord stimulation in medically intractable orthostatic tremor
J K Krauss1, R Weigel, C Blahak
1Department of Neurosurgery, Medical University, MHH, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. krauss.joachim@mh-hannover.de
Background:
Orthostatic tremor with its sense of unsteadiness when standing may have a devastating effect on affected persons. Currently, there are no other treatment options in those who do not respond or who do not tolerate medical treatment.
Objectives:
To report on a pilot study on spinal cord stimulation in medically intractable orthostatic tremor.
Methods:
Chronic spinal cord stimulation (SCS) was performed in two patients with medically-intractable orthostatic tremor via quadripolar plate electrodes implanted at the lower thoracic spine. The electrodes were connected to implantable pulse generators.
Results:
Subjective and objective improvement of unsteadiness was achieved within a frequency range of 50 to 150 Hz, and occurred in the presence of stimulation-induced paraesthesia. With optimized stimulation settings polygraphic electromyelogram (EMG) recordings continued to show the typical 14-16 Hz EMG activity. The beneficial effect of SCS was maintained at long-term follow-up.
Conclusions:
The results of this pilot study indicate that SCS may be an option in patients with otherwise intractable orthostatic tremor.