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Novel treatment (new drug/intervention; established drug/procedure in new situation)
CASE REPORT
Cervical spinal cord stimulation for the treatment of essential tremor
  1. Marc Russo1,
  2. Danielle M Santarelli1,
  3. Ushtana Smith2
  1. 1Hunter Pain Clinic, Broadmeadow, New South Wales, Australia
  2. 2Boston Scientific Neuromodulation, Mascot, New South Wales, Australia
  1. Correspondence to Dr Marc Russo, algoguy{at}gmail.com

Summary

A patient with refractory essential tremor of the hands and head/neck refused deep brain stimulation and requested consideration for spinal cord stimulation (SCS). Trial of a cervical SCS system using a basic tonic waveform produced positive outcomes in hand tremor, head-nodding and daily functioning. The patient proceeded to implant and received regular programming sessions. Outcomes were recorded at follow-ups (1, 3, 6, 12, 23 months postimplant) and included patient self-reported changes, clinical observations, handwriting assessments and The Essential Tremor Rating Assessment Scale scores. Trial of a paraesthesia-free burst waveform programme produced a small improvement in head-nodding, without uncomfortable paraesthesias. With continued programming, the patient reported further improvements to tremor and functionality, with minimal tremor remaining at 12–23 months. No major side effects were reported.

  • movement disorders (other than parkinsons)
  • spinal cord

https://doi.org/10.1136/bcr-2018-224347

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    Footnotes

    • Contributors MR consulted the patient, implanted the stimulator and performed follow-up consultations. US provided assistance with programming of the stimulator and follow-up of the patient. MR, US and DMS contributed to the interpretation of the results and production of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Disclaimer This investigation was neither sponsored nor instigated by Boston Scientific.

    • Competing interests MR consults for Medtronic, Abbott, Boston Scientific, Nevro Corp, Stimwave, Saluda Medical and Mainstay Medical. He has received travel support from Boston Scientific. US is employed by Boston Scientific Corp as a territory manager in Australia and provided assistance with programming of the stimulator. DMS has no conflicts of interest to declare.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.