Spinal cord stimulation for multiple sclerosis: quantifiable benefits.
From 1984 to 1991, a quantitative study of 5 multiple sclerosis (MS) patients has been determining benefits from epidural (C7-T1 level) spinal cord stimulation (SCS). The 5 patients (4 male, 1 female; 4 tetraparetics, 1 hemiparetic) were 36-45 years of age having had symptoms for 12-22 years. Five quantitative tests were given prior to and during SCS on 4-8 occasions; 'off' periods were planned and also did occur when the electrode(s) broke (3 patients). With SCS, hand dynamometry showed a 2- to 4-fold increase in the 3 patients with weak hand function. Jebson Hand Time Testing showed a rapidity improvement to 1/2-1/7 of time in the same 3 patients. Minnesota Manipulation Testing with SCS was improved to 1/3-1/2 of time in 2 of these 3 patients tested. Manual muscle strength increased in all patients by 20-50% in 'normal range'. Ambulation in the parallel bars increased with SCS in 2 of the 4 wheelchair patients, while the hemiparetic patient could walk without his cane. All patients showed varying quantifiable improvements with SCS, but over the duration of testing the patients slowly deteriorated. SCS is a rehabilitation option for the weakened MS patient, to be used earlier rather than later in the deterioration of MS patients.
Davis
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Section of Neurosurgery, Veterans Administration Medical Center, Augusta, Me.
Emmonds
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D000328:Adult; D004599:Electric Stimulation Therapy; D005260:Female; D005500:Follow-Up Studies; D006225:Hand; D006429:Hemiplegia / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000503:physiopathology / Q000628:therapy*; D009132:Muscles / Q000503:physiopathology; D011782:Quadriplegia / Q000503:physiopathology