ABSTRACT
Tremor is the most common movement disorder in multiple sclerosis (MS).[1] It usually occurs in association with other symptoms of MS, and its severity usually correlates with the degree of dysarthria, dysmetria, and dysdiadokinesia plus that of other neurologic manifestations of MS. However, at times tremor may be disabling out of proportion to other manifestations of ataxia and other MS symptoms. Lesions involving cerebellar white matter and nuclei can cause tremor. In addition, lesions in a variety of cerebellar afferent tracts (e.g. frontal and parietal cortex, corticocerebellar pathways through the ventral pons, the brachium pontis, restiform body) and cerebellar outflow tracts (e.g. brachium conjunctivum, red nucleus, thalamus) can also produce tremor. Medical and rehabilitative therapies for MS tremor are of limited efficacy. Stereotactic thalamotomy and deep brain stimulation (DBS) have been used with some success in carefully selected candidates.
