• J K Krauss, R Weigel, C Blahak, H Bäzner, H-H Capelle, E Grips, M Rittmann, and J C Wöhrle.
• Department of Neurosurgery, Medical University, MHH, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. krauss.joachim@mh-hannover.de
• J. Neurol. Neurosurg. Psychiatr. 2006 Sep 1;77(9):1013-6.

BackgroundOrthostatic 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.ObjectivesTo report on a pilot study on spinal cord stimulation in medically intractable orthostatic tremor.MethodsChronic 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.ResultsSubjective 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.ConclusionsThe results of this pilot study indicate that SCS may be an option in patients with otherwise intractable orthostatic tremor.

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