Targeting thalamic tremor cells in deep brain stimulation for multiple sclerosis-induced complex tremor

BACKGROUND: Tremor is an important cause of disability in patients with multiple sclerosis (MS). It is an ongoing debate as to which brain region should be targeted in MS patients with complex tremors. CASE DESCRIPTION: Here, we describe our experience with targeting thalamic tremor cells in the ventro-intermediate/ventro-oralis posterior (Vim/Vop) region in a patient with MS related complex tremor. Intraoperative multiple-microelectrode recordings showed the existence of tremor cells. Test stimulation produced the best effect when performed at the regions where tremor cells were recorded. Postoperative examination revealed a substantial improvement of the tremor. CONCLUSION: Our case observation reveals the existence of a neurophysiological target for deep brain stimulation (DBS) in MS related tremor.