Intention tremor (or cerebellar tremor) is a common symptom in MS patients. It is characterized by a slow, broad shaking that occurs at the end of an intended movement. Of course, this can have a major impact on quality of life.
A new study examined the effect of the oral anticonvulsant drug Levetiracetam (better known by its brand name of Keppra (r)) on 11 MS patients with intention tremor. Happily, administration of Keppra was associated with an improvement in both subjective and objective tests. Furthermore, the degree of improvement was not associated with the underlying multiple sclerosis disease severity or duration.
Of course, this trial was small, short, and open-label (no placebo arm), so the findings must be considered promising but preliminary. However, given the ready availability of Keppra and the difficulty in managing tremor, this is an interesting study to discuss with one's doctor when suffering from this particularl symptom of MS.
Click "read more" for the study abstract.
Full Abstract
J Neurol. 2006 May 12;
Levetiracetam for cerebellar tremor in multiple sclerosis : An open-label pilot tolerability and efficacy study.
Striano P, Coppola A, Vacca G, Zara F, Brescia Morra V, Orefice G, Striano S.
Department of Neurological Sciences, Federico II University, Via Pansini 5, 80131, Naples, Italy.
PURPOSE: Disabling tremor is frequent in multiple sclerosis (MS) and its treatment remains challenging. We conducted an open-label trial to evaluate the effect of levetiracetam (LEV) to treat cerebellar tremor in MS patients.PATIENTS AND METHODS: Fourteen MS patients, aged 27 to 57 years, with cerebellar tremor. Tremor duration ranged from 3 to 14 years. The tremor clinical rating scale, the spiral drawings scale, and ataxia clinical scale were used to assess the severity of tremor. Data about the tremor-induced disability were obtained by using the specific Activities of Daily Living Questionnaire (ADL). LEV was orally administered at a starting dose of 500 mg twice daily for one week followed by increments of 500 mg twice daily each week up to the target dose of 50 mg/Kg/day. Patients were evaluated at baseline and two weeks after the end of titration phase. The Wilcoxon matched-pairs test was used for statistical analysis.RESULTS: Eleven patients completed the trial. LEV administration was associated with subjective and objective improvement of the tremor, with significant lowering of all tremor measurements' sum of scores as well as of ADL mean score between the baseline and follow-up. No correlation was found between the degree of improvement of the tremor and the disease duration or progression. LEV was well tolerated by subjects who completed the study.CONCLUSIONS: LEV could be useful for the management of cerebellar tremor in MS and the good tolerability makes it easy to test. LEV long-term efficacy should be confirmed in extended studies.
PMID: 16683063 [PubMed - as supplied by publisher]
