Deuschl Günther
Department of Neurology, University-Hospital-Schleswig-Holstein, Campus Kiel, Christian-Albrechts-University Kiel, Kiel, Germany.
Neurodegener Dis Manag. 2016 Dec;6(6s):31-35. doi: 10.2217/nmt-2016-0053.
Hyperkinetic movement disorders such as tremors are not uncommon in patients with multiple sclerosis (MS). The classical feature is intention tremor, whereas rest tremors appear not to occur. Treatment is mainly invasive, with options of Gamma Knife surgery, thalamotomy or deep brain stimulation depending on individual circumstances. Deep brain stimulation is the only option for patients who require a bilateral intervention. All treatment recommendations have only low evidence. Tremors can also be cured spontaneously by a subsequent strategic MS lesion. Paroxysmal dyskinesias are rarer than tremors. The rarest MS movement disorder is symptomatic paroxysmal choreoathetosis, tonic spasms or 'brain stem fits'; attacks are short but frequent, up to 200 per day and generally respond well to carbamazepine.
多动性运动障碍，如震颤，在多发性硬化症（MS）患者中并不少见。典型特征是意向性震颤，而静止性震颤似乎不会出现。治疗主要是侵入性的，根据个体情况可选择伽玛刀手术、丘脑切开术或脑深部电刺激。脑深部电刺激是需要双侧干预患者的唯一选择。所有治疗建议的证据都很薄弱。震颤也可通过随后出现的策略性MS病灶自发治愈。阵发性运动障碍比震颤少见。最罕见的MS运动障碍是症状性阵发性舞蹈手足徐动症、强直性痉挛或“脑干发作”；发作短暂但频繁，每天可达200次，通常对卡马西平反应良好。
