Tags

Type your tag names separated by a space and hit enter

Subthalamic stimulation for cervical dystonia.
Acta Neurochir (Wien). 2020 08; 162(8):1879-1881.AN

Abstract

The globus pallidus internus (GPi) has been the primary target for deep brain stimulation (DBS) to treat severe medication-refractory dystonia. Some patients with primary cervical dystonia do not respond adequately to GPi stimulation. Subthalamic nucleus (STN) DBS may provide an alternative choice for treating this dystonia. In this study, we analysed the effect of bilateral STN DBS on two patients of medically refractory primary cervical dystonia. The severity of the dystonia was measured using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) preoperatively, and 1, 3, 6 and 12 months postoperatively and yearly follow-up was performed. Any change in mental status was recorded using the Mini-Mental State Examination (MMSE) score. Surgery was performed using the Leksell stereotactic system and by fusing CT scan and MR images with neuronavigation and microelectrode recording. Both patients were followed for more than 3 years. STN DBS was well-tolerated by both patients with no adverse effects. The benefit seems to be immediate. The first patient showed 74% improvement, and the second patient showed 84.3% improvement in the overall TWSTRS score. No mental deterioration was observed in either of the cases, as the MMSE score remained unchanged in both patients. A prior bilateral pallidal lesion in the first case did not adversely affect the outcome. This study showed that bilateral STN DBS results in a very significant improvement in cervical dystonia with no mental worsening and suggests that STN DBS may be an alternative to GPi DBS for treating primary cervical dystonia.

Authors+Show Affiliations

Metro Heart Institute with Multispecialty, Sector 16A, Faridabad, Haryana, 121007, India. alokg7823@gmail.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32034497

Citation

Gupta, Alok. "Subthalamic Stimulation for Cervical Dystonia." Acta Neurochirurgica, vol. 162, no. 8, 2020, pp. 1879-1881.
Gupta A. Subthalamic stimulation for cervical dystonia. Acta Neurochir (Wien). 2020;162(8):1879-1881.
Gupta, A. (2020). Subthalamic stimulation for cervical dystonia. Acta Neurochirurgica, 162(8), 1879-1881. https://doi.org/10.1007/s00701-020-04253-5
Gupta A. Subthalamic Stimulation for Cervical Dystonia. Acta Neurochir (Wien). 2020;162(8):1879-1881. PubMed PMID: 32034497.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Subthalamic stimulation for cervical dystonia. A1 - Gupta,Alok, Y1 - 2020/02/07/ PY - 2019/11/25/received PY - 2020/01/28/accepted PY - 2020/2/9/pubmed PY - 2020/2/9/medline PY - 2020/2/9/entrez KW - Deep brain stimulation KW - Dystonia KW - Movement disorders KW - Subthalamus KW - Surgery SP - 1879 EP - 1881 JF - Acta neurochirurgica JO - Acta Neurochir (Wien) VL - 162 IS - 8 N2 - The globus pallidus internus (GPi) has been the primary target for deep brain stimulation (DBS) to treat severe medication-refractory dystonia. Some patients with primary cervical dystonia do not respond adequately to GPi stimulation. Subthalamic nucleus (STN) DBS may provide an alternative choice for treating this dystonia. In this study, we analysed the effect of bilateral STN DBS on two patients of medically refractory primary cervical dystonia. The severity of the dystonia was measured using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) preoperatively, and 1, 3, 6 and 12 months postoperatively and yearly follow-up was performed. Any change in mental status was recorded using the Mini-Mental State Examination (MMSE) score. Surgery was performed using the Leksell stereotactic system and by fusing CT scan and MR images with neuronavigation and microelectrode recording. Both patients were followed for more than 3 years. STN DBS was well-tolerated by both patients with no adverse effects. The benefit seems to be immediate. The first patient showed 74% improvement, and the second patient showed 84.3% improvement in the overall TWSTRS score. No mental deterioration was observed in either of the cases, as the MMSE score remained unchanged in both patients. A prior bilateral pallidal lesion in the first case did not adversely affect the outcome. This study showed that bilateral STN DBS results in a very significant improvement in cervical dystonia with no mental worsening and suggests that STN DBS may be an alternative to GPi DBS for treating primary cervical dystonia. SN - 0942-0940 UR - https://www.unboundmedicine.com/medline/citation/32034497/Subthalamic_stimulation_for_cervical_dystonia_ L2 - https://dx.doi.org/10.1007/s00701-020-04253-5 DB - PRIME DP - Unbound Medicine ER -
Try the Free App:
Prime PubMed app for iOS iPhone iPad
Prime PubMed app for Android
Prime PubMed is provided
free to individuals by:
Unbound Medicine.