Chronic spinal cord stimulation in medically intractable orthostatic tremor.
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.


OBJECTIVE
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.
Krauss
J K
JK
Department of Neurosurgery, Medical University, MHH, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. krauss.joachim@mh-hannover.de
Weigel
R
R
Blahak
C
C
Bäzner
H
H
Capelle
H-H
HH
Grips
E
E
Rittmann
M
M
Wöhrle
J C
JC
D000368:Aged; D004599:Electric Stimulation Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011187:Posture; D013116:Spinal Cord / Q000502:physiology*; D016896:Treatment Outcome; D014202:Tremor / Q000628:therapy*