Multiple sclerosis surgery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.

Overview

Surgery can be helpful in managing refractory trigeminal neuralgia, tremors, and ataxia.

Surgery is not the first-line treatment option for patients with multiple sclerosis, but can be helpful in managing refractory symptoms including:

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]

↑ ^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.