scholarly journals Long-term Efficacy of GPi DBS for Cranio Facial Dystonia: a Retrospective Report of 13 Cases

2021 ◽  
Author(s):  
Haibo Ren ◽  
Rong Wen ◽  
Wei Wang ◽  
Denghui Li ◽  
Mengqi Wang ◽  
...  
Keyword(s):  
Rating Scale ◽  
Three Dimensional ◽  
Implanted Electrodes ◽  
Term Efficacy ◽  
Meige Syndrome ◽  
Score Improvement ◽  
Dimensional Reconstruction ◽  
Facial Dystonia

Abstract Objective: This study evaluated the long-term efficacy of globus pallidus internus (GPi) deep brain stimulation (DBS) in the treatment of Cranio Facial dystonia (Meige syndrome) and investigated the correlation between the volume of tissue activated (VTA) of the GPi and each subregion and movement score improvement.Methods: We retrospectively analyzed the clinical data of 13 patients with drug-refractory Meige syndrome who were treated with GPi DBS. Pre- and postoperative Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) scores were compared. Relationships between preoperative baseline variables and improvement in the BFMDRS-Movement (BFMDRS-M) score were analyzed. LEAD-DBS software was used for three-dimensional reconstruction of the GPi and implanted electrodes. Correlations between the GPi-VTA and score improvement were analyzed.Results: The average follow-up period was 36.6±11.0 months (18-55 months). The improvements in the BFMDRS-M score were 58.2% and 54.6% at 3 months after stimulation and at the final follow-up visit, respectively, and the improvements in the BFMDRS-Disability (BFMDRS-D) score were 53.6% and 51.7%, respectively. At the final follow-up visit, the improvements in BFMDRS-M scores for the eye, mouth, and speech/swallowing were significant (P<0.001). Age was an independent predictor of improvement in the BFMDRS-M score after DBS (P=0.005). A decrease in the BFMDRS-M score had significant positive relationships with the GPi-VTA (r=0.757, P=0.003). Conclusions: GPi DBS is an effective method to treat drug-refractory Meige syndrome. LEAD-DBS software can be used as an effective aid for visualization programing after DBS.

Long-term outcome of pallidal stimulation for Meige syndrome

2018 ◽  
Vol 130 (1) ◽  
pp. 84-89 ◽  
Author(s):  
Shiro Horisawa ◽  
Taku Ochiai ◽  
Shinichi Goto ◽  
Takeshi Nakajima ◽  
Nobuhiko Takeda ◽  
...  
Keyword(s):  
Rating Scale ◽  
Small Scale ◽  
Initial Symptom ◽  
Long Term Outcome ◽  
Time Points ◽  
Meige Syndrome ◽  
Pallidal Stimulation ◽  
The Mean

OBJECTIVEMeige syndrome is characterized by blepharospasm and varied subphenotypes of craniocervical dystonia. Current literature on pallidal surgery for Meige syndrome is limited to case reports and a few small-scale studies. The authors investigated the clinical outcomes of deep brain stimulation (DBS) of the globus pallidus internus (GPi) in patients with Meige syndrome.METHODSSixteen patients who underwent GPi DBS at the Tokyo Women’s Medical University Hospital between 2002 and 2015 were included in this study. Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) movement subscale (BFMDRS-M) scores (range 0–120) obtained at the following 3 time points were included in this analysis: before surgery, 3 months after surgery, and at the most recent follow-up evaluation.RESULTSThe patients’ mean age (± SD) at symptom onset was 46.7 ± 10.1 years, and the mean disease duration at the time of the authors’ initial evaluation was 5.9 ± 4.1 years. In 12 patients, the initial symptom was blepharospasm, and the other 4 patients presented with cervical dystonia. The mean postoperative follow-up period was 66.6 ± 40.7 months (range 13–150 months). The mean total BFMDRS-M scores at the 3 time points were 16.3 ± 5.5, 5.5 ± 5.6 (66.3% improvement, p < 0.001), and 6.7 ± 7.3 (58.9% improvement, p < 0.001).CONCLUSIONSThe results indicate long-term efficacy for GPi DBS for the majority of patients with Meige syndrome.

Low-Voltage Bilateral Pallidal Stimulation for Severe Meige Syndrome in a Patient With Primary Segmental Dystonia: Case Report

2010 ◽  
Vol 67 (3) ◽  
pp. ons-ons ◽  
Author(s):  
Luigi M. Romito ◽  
Antonio E. Elia ◽  
Angelo Franzini ◽  
Orso Bugiani ◽  
Alberto Albanese
Keyword(s):  
Low Voltage ◽  
Sustained Improvement ◽  
3 Dimensional ◽  
Meige Syndrome ◽  
Pallidal Stimulation ◽  
Segmental Dystonia ◽  
Dimensional Reconstruction ◽  
Observation Period

Abstract BACKGROUND AND IMPORTANCE: Meige syndrome (MS) is an adult-onset segmental dystonia characterized by the combination of upper and lower cranial involvement. Its treatment is challenging and the use of oral medication or of botulinum neurotoxin treatment is not decisive. Deep brain stimulation of the globus pallidus internum (GPi DBS) has been used occasionally in severe cases. CLINICAL PRESENTATION: We report the long-term efficacy of low-voltage chronic bilateral GPi DBS in a patient with segmental dystonia featuring severe MS and cervical brachial involvement. The patient received a bilateral ventroposterolateral GPi implant. Postoperative 3-dimensional reconstruction allowed checking of the definitive position of the electrode and contacts within the targeted nucleus. Following implant, the patient received bilateral low-voltage stimulation, consisting in amplitude of 1.3 V with a pulse width of 90 microseconds and a frequency of 130 Hz, yielding a current of 23 µA. Clinical follow-up for 38 months showed a progressive and sustained improvement of dystonia with unchanged electrical settings throughout the observation period. The patient again undertook normal life activities. CONCLUSION: Bilateral low-voltage GPi stimulation allowed efficient control of MS symptoms and the associated brachial cervical dystonia.

scholarly journals Evaluating the Long-Term Efficacy of COVID-19 Vaccines

2021 ◽  
Author(s):  
Dan-Yu Lin ◽  
Donglin Zeng ◽  
Peter B Gilbert
Keyword(s):  
Large Scale ◽  
Crossover Designs ◽  
Phase 3 ◽  
Term Efficacy ◽  
Timely Access ◽  
Efficacious Vaccine ◽  
Trial Participants ◽  
Ongoing Phase

Abstract Large-scale deployment of safe and durably effective vaccines can curtail the COVID-19 pandemic.1−3 However, the high vaccine efficacy (VE) reported by ongoing phase 3 placebo-controlled clinical trials is based on a median follow-up time of only about two months4−5 and thus does not pertain to long-term efficacy. To evaluate the duration of pro- tection while allowing trial participants timely access to efficacious vaccine, investigators can sequentially cross participants over from the placebo arm to the vaccine arm according to priority groups. Here, we show how to estimate potentially time-varying placebo-controlled VE in this type of staggered vaccination of participants. In addition, we compare the per- formance of blinded and unblinded crossover designs in estimating long-term VE.

scholarly journals Successful in a conservative treatment of osteoradionecrosis of the jaw: a case report and review of literature

2016 ◽  
Vol 64 (2) ◽  
pp. 212-218
Author(s):  
Paulo de Camargo MORAES ◽  
Luiz Alexandre THOMAZ ◽  
Milena Bortolotto Felippe SILVA ◽  
José Luiz Cintra JUNQUEIRA ◽  
Rubens Gonçalves TEIXEIRA
Keyword(s):  
Conservative Management ◽  
Three Dimensional ◽  
Clinical Aspect ◽  
Dental Extraction ◽  
Review Of Literature ◽  
Nonoperative Therapy ◽  
Exposed Bone ◽  
Regular Review

ABSTRACT Osteoradionecrosis of jaws is one of the most serious complications of radiation therapy for head and neck malignancies. The management of osteoradionecrosis continues to be debated and there are few cases which can be resolved with conservative management. This paper presents a case of osteoradionecrosis after a dental extraction affecting the mandible of a 58-year-old man and highlights the conservative therapeutic management and 3-year follow-up period. We combined a conservative nonoperative therapy, including long-term antibiotic therapy and daily irrigation with chlorhexidine mouthrinses in a case of osteoradionecrosis after a dental extraction affecting the mandible of a 58-year-old man. At the follow-up, clinical aspect was resolved. A CBCT scan image and a three-dimensional (3D) reconstructed image revealed bone remodeling in a 3-year follow-up period .No sign of exposed bone could be seen. Follow-up 3 years later revealed that the conservative management posed was successful for osteoradionecrosis and the patient is currently under regular review.

Sign in / Sign up

Export Citation Format

Share Document