title: Tremor in multiple sclerosis.
abstract: Tremor is estimated to occur in about 25 to 60 percent of patients with multiple sclerosis (MS). This symptom, which can be severely disabling and embarrassing for patients, is difficult to manage. Isoniazid in high doses, carbamazepine, propranolol and gluthetimide have been reported to provide some relief, but published evidence of effectiveness is very limited. Most trials were of small size and of short duration. Cannabinoids appear ineffective. Tremor reduction can be obtained with stereotactic thalamotomy or thalamic stimulation. However, the studies were small and information on long-term functional outcome is scarce. Physiotherapy, tremor reducing orthoses, and limb cooling can achieve some functional improvement. Tremor in MS remains a significant challenge and unmet need, requiring further basic and clinical research.
authors.affiliation: Department of Neurology, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands. m.w.koch@neuro.umcg.nl
authors.forename: Marcus
authors.initials: M
authors.lastname: Koch
authors.forename: Jop
authors.initials: J
authors.lastname: Mostert
authors.forename: Dorothea
authors.initials: D
authors.lastname: Heersema
authors.forename: Jacques
authors.initials: J
authors.lastname: De Keyser
mesh_terms: D006801:Humans; D009103:Multiple Sclerosis / Q000150:complications* / Q000453:epidemiology; D016896:Treatment Outcome; D014202:Tremor / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy*