MS Tremor – Cerebellar Intention Tremor — SCE Neurology MCQ

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EasyMultiple Sclerosis & CNS InflammationMS Tremor – Cerebellar Intention TremorSCE Neurology

A 55-year-old man with MS develops a severe tremor affecting his right arm that prevents him from feeding himself. His neurologist measures the tremor using the Fahn-Tolosa-Marin Tremor Rating Scale. What type of tremor is most common in MS?

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Correct answer: B — Intention (cerebellar) tremor — caused by cerebellar pathway demyelination

The most common tremor type in MS is intention (cerebellar) tremor, resulting from demyelination of the cerebellar pathways (particularly the superior cerebellar peduncle and cerebellar white matter connections). It is an action tremor that worsens as the limb approaches its target (terminal kinetic tremor). It can be extremely disabling and is notoriously difficult to treat pharmacologically. A: Resting tremor is characteristic of PD, not MS. C: Postural tremor can occur but intention tremor is more common and disabling. D: Physiological tremor is normal. E: Drug-induced tremor is a separate entity.

Reference: NICE NG100 MS; ABN MS Guidelines