Objective: To describe the clinical characteristics of tremor in multiple sclerosis (MS) patients in Nepal and assess its functional impact on daily living. To describe the clinical characteristics of tremor in multiple sclerosis (MS) patients in Nepal and assess its functional impact on daily living.

Background: Tremor is a disabling yet under-recognized manifestation of MS, particularly in low-resource settings where access to specialized care and advanced therapies is limited. Data from South Asia, including Nepal, remains scarce, limiting context-specific clinical decision-making.

Method: A cross-sectional observational study was conducted at two tertiary neurology centers in Nepal between January 2023 and June 2024. Consecutive adults with clinically definite MS were evaluated. Tremor was assessed using the Fahn–Tolosa–Marín Tremor Rating Scale (FTM-TRS). Disability was measured using the Expanded Disability Status Scale (EDSS), and functional impact was assessed using the tremor-related activities of daily living (ADL) score. Descriptive and comparative analyses were performed.

Results: Among 62 MS patients (mean age 34.8 ± 9.6 years; 71% female), tremor was present in 24 (38.7%). Intention tremor was the most common subtype (62.5%), followed by postural tremor (29.2%). Patients with tremor had higher median EDSS scores than those without tremor (4.0 vs 2.5). Moderate to severe functional impairment was reported by 58.3% of tremor-positive patients, particularly affecting handwriting, feeding, and dressing. Tremor severity showed a positive correlation with disease duration (r = 0.46).

Conclusion: Tremor affects over one-third of MS patients in Nepal and is associated with greater disability and meaningful functional limitations. Early recognition and targeted multidisciplinary interventions are crucial for enhancing quality of life in resource-limited settings.

Table 2

Table 1

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MDS Abstracts - https://www.mdsabstracts.org/abstract/clinical-characteristics-and-functional-impact-of-tremor-in-patients-with-multiple-sclerosis-in-nepal-a-cross-sectional-observational-study/