Multiple sclerosis surgery
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Surgery
Surgery is not the first-line treatment option for patients with multiple sclerosis but can be helpful in managing some symptoms:
Trigeminal Neuralgia
If we fail to treat trigeminal neuralgia with medication, surgery can be an option. In order to reduce pain transmission to brain we can apply more damage to the nerve and reduce this transmission.[1]
Tremor and Ataxia
If all these measures fail some patients are candidates for thalamus surgery. This kind of surgery can be both a thalamotomy or the implantation of a thalamic stimulator. Complications are frequent (30% in thalamotomy and 10% in deep brain stimulation) and include a worsening of ataxia, dysarthria and hemiparesis.
Thalamotomy is a more efficacious surgical treatment for intractable MS tremor, however the higher incidence of persistent neurological deficits in patients receiving lesional surgery supports the use of deep brain stimulation as the preferred surgical strategy.[2]
References
- ↑ 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.
- ↑ 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.