Multiple sclerosis surgery: Difference between revisions
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==Overview== | ==Overview== | ||
Surgery can be helpful in | Surgery can be helpful in managing refractory [[trigeminal neuralgia]], [[tremors]], and [[ataxia]]. | ||
== Indications == | == Indications == | ||
[[Surgery]] is not the [[first-line treatment]] option for patients with multiple sclerosis, but can be helpful in managing | [[Surgery]] is not the [[first-line treatment]] option for patients with multiple sclerosis, but can be helpful in managing refractory [[Symptom|symptoms]] including: | ||
* Trigeminal neuralgia<ref name=":0" /> | |||
* Tremor<ref name=":1" /> | |||
* Ataxia<ref name=":1" /> | |||
==Surgery== | ==Surgery== | ||
====Trigeminal neuralgia==== | ====Trigeminal neuralgia==== | ||
If we fail to treat trigeminal neuralgia with medication, surgery can be an option. In order to reduce pain transmission to the brain, we can apply more damage to the nerve and reduce this transmission.<ref>{{cite journal |author=Kondziolka D, Lunsford LD, Bissonette DJ |title=Long-term results after glycerol rhizotomy for multiple sclerosis-related trigeminal neuralgia |journal=The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques |volume=21 |issue=2 |pages=137-40 |year=1994 |pmid=8087740 |doi=}}</ref> | If we fail to treat trigeminal neuralgia with medication, surgery can be an option. In order to reduce pain transmission to the brain, we can apply more damage to the nerve and reduce this transmission.<ref name=":0">{{cite journal |author=Kondziolka D, Lunsford LD, Bissonette DJ |title=Long-term results after glycerol rhizotomy for multiple sclerosis-related trigeminal neuralgia |journal=The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques |volume=21 |issue=2 |pages=137-40 |year=1994 |pmid=8087740 |doi=}}</ref> | ||
====Tremor and Ataxia==== | ====Tremor and Ataxia==== | ||
Using [[surgery]] for treatment of [[tremor]] and [[ataxia]] includes [[thalamotomy]] and implantation of a [[thalamic stimulator]]. Evidence shows that [[thalamotomy]] is more effective, but because of more serious [[side effects]], brain stimulation is more preferable.<ref>{{cite journal |author=Bittar RG, Hyam J, Nandi D, Wang S, Liu X, Joint C, Bain PG, Gregory R, Stein J, Aziz TZ|title=Thalamotomy versus thalamic stimulation for multiple sclerosis tremor |journal=Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia |volume=12 |issue=6 |pages=638-42 |year=2005 |pmid=16098758|doi=10.1016/j.jocn.2004.09.008}}</ref> | Using [[surgery]] for treatment of [[tremor]] and [[ataxia]] includes [[thalamotomy]] and implantation of a [[thalamic stimulator]]. Evidence shows that [[thalamotomy]] is more effective, but because of more serious [[side effects]], brain stimulation is more preferable.<ref name=":1">{{cite journal |author=Bittar RG, Hyam J, Nandi D, Wang S, Liu X, Joint C, Bain PG, Gregory R, Stein J, Aziz TZ|title=Thalamotomy versus thalamic stimulation for multiple sclerosis tremor |journal=Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia |volume=12 |issue=6 |pages=638-42 |year=2005 |pmid=16098758|doi=10.1016/j.jocn.2004.09.008}}</ref> | ||
==References== | ==References== | ||
Revision as of 16:33, 3 December 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Irfan Dotani
Overview
Surgery can be helpful in managing refractory trigeminal neuralgia, tremors, and ataxia.
Indications
Surgery is not the first-line treatment option for patients with multiple sclerosis, but can be helpful in managing refractory symptoms including:
Surgery
Trigeminal neuralgia
If we fail to treat trigeminal neuralgia with medication, surgery can be an option. In order to reduce pain transmission to the brain, we can apply more damage to the nerve and reduce this transmission.[1]
Tremor and Ataxia
Using surgery for treatment of tremor and ataxia includes thalamotomy and implantation of a thalamic stimulator. Evidence shows that thalamotomy is more effective, but because of more serious side effects, brain stimulation is more preferable.[2]
References
- ↑ 1.0 1.1 Kondziolka D, Lunsford LD, Bissonette DJ (1994). "Long-term results after glycerol rhizotomy for multiple sclerosis-related trigeminal neuralgia". The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques. 21 (2): 137–40. PMID 8087740.
- ↑ 2.0 2.1 2.2 Bittar RG, Hyam J, Nandi D, Wang S, Liu X, Joint C, Bain PG, Gregory R, Stein J, Aziz TZ (2005). "Thalamotomy versus thalamic stimulation for multiple sclerosis tremor". Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia. 12 (6): 638–42. doi:10.1016/j.jocn.2004.09.008. PMID 16098758.