Indications and approaches for functional neurosurgery in multiple sclerosis, including the role for lesional surgery and deep brain stimulation

Multiple sclerosis is a chronic and disabling condition of the central nervous system, associated with variable and wide-ranging symptoms. In some patients, functional neurosurgery may be considered for the relief of symptoms including tremor and pain. This could include lesional surgery or deep brain stimulation. In this review we evaluate the evidence for lesional neurosurgery and deep brain stimulation in multiple sclerosis, comparing these approaches and associated outcomes, and identifying the key symptoms which are thought to be amenable to intervention.