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Tremor and other Movement Disorders

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Symptom: Involuntary rhythmical movements of the trunk, limbs, head and/or vocal cords

Tremor, the most common movement disorder in MS, can be the least treatable and most debilitating symptom of MS. Other movement disorders seen in MS include: tonic spasms (spasticity), focal dystonia, focal/segmental myoclonus, chorea, parkinsonism and restless leg syndrome.

Treatment

  • Referral to PT for balance/coordination exercises;
  • Referral to OT for tools; weights on limbs, eating or writing utensils
  • Propranolol clonazepam, hydroxyzine, primidone, isoniazid, topiramate, buspirone, ondansetron, gabapentin (evidence is lacking on the efficacy of any medication; however, a number of different agents have been tried)
  • Other: Deep brain stimulation may be considered (Oliveria SF et al. 2017)

Psychosocial Implication

  • Loss of control
  • Somnolence caused by medications
  • Loss of employment
  • Social isolation

Resources for patients

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