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Chronic spinal cord stimulation in medically intractable orthostatic tremor
  1. J K Krauss1,2,
  2. R Weigel1,
  3. C Blahak3,
  4. H Bäzner3,
  5. H-H Capelle1,2,
  6. E Grips3,
  7. M Rittmann4,
  8. J C Wöhrle3
  1. 1Department of Neurosurgery, University Hospital, Mannheim, Germany
  2. 2Department of Neurosurgery, Medical University, MHH, Hannover, Germany
  3. 3Department of Neurology, University Hospital, Mannheim
  4. 4Department of Neurology, Diakoniekrankenhaus, Mannheim
  1. Correspondence to:
 J K Krauss
 Department of Neurosurgery, Medical University, MHH, Carl-Neuberg-Str. 1, 30625 Hannover, Germany;krauss.joachim{at}mh-hannover.de

Abstract

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

https://doi.org/10.1136/jnnp.2005.086132

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    Footnotes

    • 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.