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Resulted in less tremor control. Recently, a long term mean of 32 months ; study of DBS in 9 medically refractory multiple sclerosis patients demonstrated a reduction of tremor in all, though improvement was greatest at the outset.29 Extended Disability Status Scale EDSS ; scores worsened over time and were on average, 6.7 before surgery, 6.8 at 6 months and 7.8 at late follow-up. Improvement in tremor scores persisted despite the fact that disability scores worsened. This is consistent with continued benefit for tremor despite progression of the underlying disease. Within one month of surgery, one-third had exacerbations of MS symptoms, requiring steroid therapy. However, one-third, had long term restitution of their ability to feed themselves and maintain independent personal hygiene when stimulated. The authors conclude after reviewing other published accounts of DBS for MSrelated tremor that the surgery is safe and effective for reducing tremor. In addition, some patients may have sustained benefit but the progressive nature of MS makes it difficult to assess functional outcomes from surgery over time. This finding is likely to hold true for any neurodegenerative cause of cerebellar tremor. Better outcome tools are required to truly determine functional outcome, disability, and quality of life following DBS so these concerns should be addressed in future trials of surgical treatment for cerebellar tremor. Although there are limitations in functional improvement as currently measured, the resistance to medical treatment and debilitating aspects of this tremor along with the low morbidity and mortality rate of DBS make the surgery an acceptable option for those appropriately selected patients with moderately to severely disabling cerebellar tremor.

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137 Formulation of a stable, sterilised vaccine against M. tuberculosis - preservation of effective immune responses V.W. Bramwell, A.R. Mohammed and Y. Perrie Aston University, Birmingham, B4 7ET, United Kingdom 138 Modelling the release of drugs from PEG 8000 solid dispersion systems to determine the mechanism of release. S. Khan, H.K. Batchelor and Y. Perrie Aston University, Birmingham, B4 7ET, United Kingdom.

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