Thalamic deep brain stimulation for treatment of visual symptoms in multiple sclerosis

Abstract

Individuals with multiple sclerosis (MS) can experience many disabling side effects associated with progression of the disease. Oscillopsia secondary to acquired nystagmus is a common visual symptom reported by patients with MS. These patients may also be disabled by tremors, which if severe, can contribute to their visual symptoms. The present treatment for acquired nystagmus and its visual symptoms remains unsatisfactory. However, the future may hold a promising treatment modality for tremor in MS patients. Stimulation of the thalamic ventral intermediate nucleus (Vim) has been utilized in the management of tremor in patients with Parkinson’s disease. The value of this therapy in movement disorders secondary to MS is uncertain, but may provide an acceptable therapeutic option. To date, no studies have been established to examine the effect of thalamic deep brain stimulation (DBS) upon visual symptoms, therefore there are no clinical data to support this treatment option in MS patients. This paper will discusses a patient who underwent DBS to reduce his tremors, and also had a reduction in his visual symptoms.