Tremor and ataxia are both symptoms of MS that impact movement. Tremor is described as an unintentional, rhythmic, muscle movement involving to-and-fro movements of one or more parts of the body.

Ataxia is described as incoordination and unsteadiness which can affect posture, walking, eye movements and speech. These symptoms are considered by health professionals to be one of the most significant challenges to successful MS management and can be very disabling.

Today there is no consistently effective medication for MS-related tremor and ataxia, although some drugs have been shown to be partially successful for some people. Unfortunately there is limited research being done in this area considering that tremor and ataxia are estimated to affect at least a third of people with MS.

While many symptoms of MS – such as fatigue – are “invisible”, tremor and ataxia are unfortunately distinctly visible. Tremor and ataxia can have a negative impact on a person’s self-esteem. Many people with even mild tremor or ataxia can be at risk of losing contact with their social networks, tending to avoid public situations due to the embarrassment these symptoms can cause. For those dealing with severe tremor or ataxia, independence in caring for one’s self and in performing day-to-day activities can be in jeopardy. Tremor and ataxia can have a negative impact on other areas of a person’s life such as their work or their sex life.

For many people with tremor or ataxia, pharmacological therapy is ineffective or only partially effective. In these cases healthcare professionals can be helpful in identifying different strategies for managing tremor in non-pharmacological ways, such as through the use of assistive aids, exercise, weighting and other means that are described in this issue of MS in focus.

This issue provides a complete discussion of tremor and ataxia from different points of view by healthcare professionals and researchers who have years of experience in these topics. The complexity of evaluating and managing tremor and ataxia, as well as the lack of effective medications, underline the need for a comprehensive approach.

I look forward to receiving your comments.

Michele Messmer Uccelli
Editor

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