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.
- EMG, electromyelogram
- PSR, patient self-rating
- SCS, spinal cord stimulation
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Published Online First 30 May 2006
Competing interests: JKK is a consultant to Medtronic.
Informed consent was obtained from the patients described in this paper.