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. 1980 Jan;43(1):1–14. doi: 10.1136/jnnp.43.1.1

Spinal cord stimulation in multiple sclerosis: clinical results.

L S Illis, E M Sedgwick, R C Tallis
PMCID: PMC490455  PMID: 7354351

Abstract

Clinical results of spinal cord stimulation by means of epidural electrodes are reported in 19 patients with multiple sclerosis. On temporary stimulation with percutaneous electrodes, significant improvement in mobility occurred in 27.7% of 18 patients and the same number showed improved sensory function. Only one of 13 patients with severe upper limb ataxia improved. The major response, both in terms of the percentage of patients responding and the extent of the responses seen was in bladder function: 75% of 16 patients with bladder symptoms improved and seven of the 11 patients with severe bladder disturbance (Kurtzke grade 3 or more) improved. Four of these seven patients had before and after cystometry and 3 showed reduced detrusor hyperreflexia. Altogether, 10 patients had a worthwhile clinical response in one or more aspects of the disease and of these, nine have so far gone on to permanent stimulation. Medium-term results (up to two years) show that, with one exception, improvement in bladder function has been maintained as long as stimulation has been continued and at least 50% of improvement in mobility has been maintained. A favourable response depends not upon the fact of stimulation but upon the type of stimulation received. This, along with other evidence, indicates that the response is not caused either by a placebo effect or by the natural fluctuation of the disease.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abbate A. D., Cook A. W., Atallah M. Effect of electrical stimulation of the thoracic spinal cord on the function of the bladder in multiple sclerosis. J Urol. 1977 Mar;117(3):285–288. doi: 10.1016/s0022-5347(17)58436-0. [DOI] [PubMed] [Google Scholar]
  2. Brown M., Wickham J. E. The urethral pressure profile. Br J Urol. 1969 Apr;41(2):211–217. doi: 10.1111/j.1464-410x.1969.tb09925.x. [DOI] [PubMed] [Google Scholar]
  3. Gildenberg P. L. Treatment of spasmodic torticollis with dorsal column stimulation. Acta Neurochir (Wien) 1977;(Suppl 24):65–66. doi: 10.1007/978-3-7091-8482-0_10. [DOI] [PubMed] [Google Scholar]
  4. Illis L. S. Enlargement of spinal cord synapses after repetitive stimulation of a single posterior root. Nature. 1969 Jul 5;223(5201):76–77. doi: 10.1038/223076a0. [DOI] [PubMed] [Google Scholar]
  5. Illis L. S., Oygar A. E., Sedgwick E. M., Awadalla M. A. Dorsal-column stimulation in the rehabilitation of patients with multiple sclerosis. Lancet. 1976 Jun 26;1(7974):1383–1386. doi: 10.1016/s0140-6736(76)93030-0. [DOI] [PubMed] [Google Scholar]
  6. Illis L. S. Regeneration in the central nervous system. Lancet. 1973 May 12;1(7811):1035–1037. doi: 10.1016/s0140-6736(73)90669-7. [DOI] [PubMed] [Google Scholar]
  7. KURTZKE J. F. On the evaluation of disability in multiple sclerosis. Neurology. 1961 Aug;11:686–694. doi: 10.1212/wnl.11.8.686. [DOI] [PubMed] [Google Scholar]
  8. MILLER H., SIMPSON C. A., YEATES W. K. BLADDER DYSFUNCTION IN MULTIPLE SCLEROSIS. Br Med J. 1965 May 15;1(5445):1265–1269. doi: 10.1136/bmj.1.5445.1265. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Melzack R., Wall P. D. Pain mechanisms: a new theory. Science. 1965 Nov 19;150(3699):971–979. doi: 10.1126/science.150.3699.971. [DOI] [PubMed] [Google Scholar]
  10. Richardson R. R., McLone D. G. Percutaneous epidural neurostimulation for paraplegic spasticity. Surg Neurol. 1978 Mar;9(3):153–155. [PubMed] [Google Scholar]
  11. SCHUMACHER G. A., BEEBE G., KIBLER R. F., KURLAND L. T., KURTZKE J. F., MCDOWELL F., NAGLER B., SIBLEY W. A., TOURTELLOTTE W. W., WILLMON T. L. PROBLEMS OF EXPERIMENTAL TRIALS OF THERAPY IN MULTIPLE SCLEROSIS: REPORT BY THE PANEL ON THE EVALUATION OF EXPERIMENTAL TRIALS OF THERAPY IN MULTIPLE SCLEROSIS. Ann N Y Acad Sci. 1965 Mar 31;122:552–568. doi: 10.1111/j.1749-6632.1965.tb20235.x. [DOI] [PubMed] [Google Scholar]
  12. Sedgwick E. M., Illis L. S., Tallis R. C., Thornton A. R., Abraham P., El-Negamy E., Docherty T. B., Soar J. S., Spencer S. C., Taylor F. M. Evoked potentials and contingent negative variation during treatment of multiple sclerosis with spinal cord stimulation. J Neurol Neurosurg Psychiatry. 1980 Jan;43(1):15–24. doi: 10.1136/jnnp.43.1.15. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Sharr M. M., Garfield J. S., Jenkins J. D. Lumbar spondylosis and neuropathic bladder: investigation of 73 patients with chronic urinary symptoms. Br Med J. 1976 Mar 20;1(6011):695–697. doi: 10.1136/bmj.1.6011.695. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Shealy C. N., Mortimer J. T., Reswick J. B. Electrical inhibition of pain by stimulation of the dorsal columns: preliminary clinical report. Anesth Analg. 1967 Jul-Aug;46(4):489–491. [PubMed] [Google Scholar]

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