Tremor and movement disorders in multiple sclerosis: indications for symptomatic treatment

Tremor and movement disorders in multiple sclerosis (MS) patients cause a s evere functional impairment. The different types of tremor observed in MS a re: cerebellor tremor with a dominant intention component, Holmes tremor ch aracterized by the addition of rest and postural components and pala tat tr emor. When no medication can improve the functional status, it is acceptabl e to discuss the deep brain stimulation in the VIM thalamus, thus making po ssible a partial attenuation of the rest and postural component, mainly aff ecting the proximal part of the affected limb. Among the movement disorders , paroxysmal dyskinesias are not rare and a good therapeutic response is ob tained with carbamazepine: dystonia and parkinsonism are usually coincident al features during MS.