Medications and surgery for tremor

MS-related tremor can be difficult to treat, but there are many different ways to manage it, including occupational and physical therapy, medications, and surgery.

A wide variety of medications have been studied for the treatment of MS tremor, including antihistamines, anti-anxiety medications, diuretics (pills that make you urinate more often), beta-blockers (medications that have a variety of effects in the body and are also used for high blood pressure), anti-spasticity medications, anti-tuberculosis, and even anti-seizure medications. Your doctor will advise you on which medication would be most appropriate for you based on your medical history and other medications you may be taking. You may need to try more than one medication before finding a medication (or combination of medications) that helps with your tremor.

Your doctor may recommend that you start a disease-modifying medication in addition to medication to help relieve your tremor. Disease-modifying medications won't directly affect your current symptoms of tremor, but they can help prevent future damage, which could help stop the tremor from getting worse.

Surgical procedures, such as thalamotomy and deep brain stimulation (DBS), have been used to treat MS tremor.

Thalamotomy uses a machine called a gamma knife to destroy nerve tissue in an area of the brain called the thalamus. Open-skull surgery is not needed. Although it may help in about two-thirds of cases, the benefits may disappear over time.

With DBS, open-skull surgery is performed to insert a small electrode in the thalamus. A wire is run to a control device in the chest area that sends electrical pulses to disrupt tremor-related nerve signals. DBS has been used for Parkinson's disease but it is still considered experimental for people with MS. For more information on surgery for tremor, speak to your doctor.

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