Both thalamic and pallidal deep brain stimulation for myoclonic dystonia

2010 ◽  
Vol 112 (6) ◽  
pp. 1267-1270 ◽  
Author(s):  
Jean Q. L. Oropilla ◽  
Cid C. E. Diesta ◽  
Parunut Itthimathin ◽  
Oksana Suchowersky ◽  
Zelma H. T. Kiss
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Rating Scales ◽  
Surgical Intervention ◽  
Double Blind ◽  
Thalamic Stimulation ◽  
Pallidal Stimulation ◽  
Pars Interna ◽  
Pallidal Deep Brain Stimulation ◽  
Deep Brain

Myoclonic dystonia is poorly managed with medication and may be severe enough to warrant surgical intervention. Surgery has targeted either the globus pallidus pars interna (GPi) or the thalamus, but there is no accepted target for this condition. The authors present the case of a 23-year-old man treated with unilateral deep brain stimulation in both the thalamus and GPi. His movement disorder improved dramatically with stimulation. Two years postoperatively, the authors performed a double-blind assessment of the effects of each stimulator together, separately, and off stimulation. Videotape assessment, using tremor, dystonia, and myoclonus rating scales, showed that most of the benefit could be attributed to pallidal stimulation, although there was some advantage to stimulation at both sites. These results suggest that while GPi stimulation may be the better target for this condition, thalamic stimulation may be added in cases in which the benefit is insufficient.

scholarly journals Pallidal Stimulation in Parkinson's Disease Patients with a Prior Unilateral Pallidotomy

1998 ◽  
Vol 25 (4) ◽  
pp. 300-305 ◽  
Author(s):  
Nestor Gálvez-Jiménez ◽  
Andres Lozano ◽  
Ronald Tasker ◽  
Janice Duff ◽  
William Hutchison ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Contralateral Side ◽  
Double Blind ◽  
Thalamic Stimulation ◽  
Symptom Profiles ◽  
Pallidal Stimulation ◽  
The Status ◽  
Unilateral Pallidotomy ◽  
Deep Brain

ABSTRACT:Objective:To evaluate, in a double-blind fashion, the efficacy of deep brain stimulation of the internal segment of the globus pallidus (GPi) contralateral to a previous unilateral medial pallidotomy (MP).Methods:This pilot study involved 4 patients with a previous MP and one previously unoperated patient unable to tolerate any antiparkinsonian drugs. One of the patients with a prior unilateral MP had two electrodes implanted in the contralateral side, one in GPi and one in Vim thalamus. Detailed neurologic assessments were performed after overnight drug withdrawal and in the drug “on” state at baseline, 1 week and 3 months (in all), and 9 and 12 months (one) with patients and evaluators blinded to the status of stimulation.Results:GPi stimulation resulted in improvements in “off-period” contralateral bradykinesia, rigidity and tremor in all patients. Dyskinesias and freezing episodes were ameliorated in one patient each but dyskinesias were transiently induced in another. The patient with GPi+Vim electrodes had complete resolution of contralateral tremor with thalamic stimulation but less benefit from acute GPi stimulation. One patient experienced a single seizure one week post-op and no other surgical complications were observed.Conclusions:Deep brain stimulation can be applied safely and effectively in patients who have already had a pallidotomy on the contralateral side. The effect of stimulation at different sites on different symptom profiles and levodopa-induced dyskinesias requires further evaluation.

scholarly journals Unilateral thalamic and pallidal deep brain stimulation for idiopathic hemidystonia: results of individual and combined stimulations. Case report

2017 ◽  
Vol 43 (1) ◽  
pp. E2 ◽  
Author(s):  
Victor Goulenko ◽  
Paulo Luiz da Costa Cruz ◽  
Paulo Niemeyer Filho
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Rating Scale ◽  
Multiple Target ◽  
Motor Pathways ◽  
Severity Rating ◽  
Pallidal Stimulation ◽  
Pallidal Deep Brain Stimulation ◽  
Deep Brain

Pallidal stimulation has been the usual surgical treatment for dystonia in the last decades. The continuous investigation of the physiopathology and the motor pathways involved leads to the search for complementary targets to improve results. The authors present the case of a 37-year-old woman who had suffered from idiopathic hemidystonia with hyperkinetic and hypokinetic movements for 11 years, and who was treated with deep brain stimulation. A brief literature review is also provided. The globus pallidus internus and the ventral intermediate/ventral oral posterior complex of the thalamus were stimulated separately and simultaneously for 3 months and compared using the Burke-Fahn-Marsden Dystonia Rating Scale and the Global Dystonia Severity Rating Scale, with a 3.5-year follow-up. The synergism of multiple-target stimulation resulted in a complete improvement of the mixed dystonic symptoms.

scholarly journals A randomized double-blind crossover trial comparing subthalamic and pallidal deep brain stimulation for dystonia

2014 ◽  
Vol 120 (1) ◽  
pp. 295
Author(s):  
Lisbeth Schjerling ◽  
Lena E. Hjermind ◽  
Bo Jespersen ◽  
Flemming F. Madsen ◽  
Jannick Brennum ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Crossover Trial ◽  
Double Blind ◽  
Pallidal Deep Brain Stimulation ◽  
Deep Brain

Anterior pallidal deep brain stimulation for Tourette's syndrome: a randomised, double-blind, controlled trial

2017 ◽  
Vol 16 (8) ◽  
pp. 610-619 ◽  
Author(s):  
Marie-Laure Welter ◽  
Jean-Luc Houeto ◽  
Stéphane Thobois ◽  
Benoit Bataille ◽  
Marc Guenot ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Controlled Trial ◽  
Tourette's Syndrome ◽  
Tourette’S Syndrome ◽  
Double Blind ◽  
Pallidal Deep Brain Stimulation ◽  
Deep Brain

Unilateral pallidal deep brain stimulation in a patient with cervical dystonia and tremor

2010 ◽  
Vol 113 (6) ◽  
pp. 1230-1233 ◽  
Author(s):  
Cristina V. Torres ◽  
Elena Moro ◽  
Jonathan O. Dostrovsky ◽  
William D. Hutchison ◽  
Yu-Yan W. Poon ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Globus Pallidus ◽  
Brain Stimulation ◽  
Cervical Dystonia ◽  
Marked Improvement ◽  
Pars Interna ◽  
Pallidal Deep Brain Stimulation ◽  
Deep Brain ◽  
Stimulation Of

Bilateral deep brain stimulation of the globus pallidus pars interna (GPi) is the favored neuromodulation procedure in cases of cervical dystonia. The authors report on a case of unilateral GPi implantation that resulted in sustained benefit with marked improvement in pain and dystonia.

scholarly journals Successful Pallidal Deep Brain Stimulation Treatment in a Case of Generalized Dystonia due to a Novel ANO3 Mutation

2019 ◽  
Vol 2019 ◽  
pp. 1-2 ◽  
Author(s):  
Lizl Lasky ◽  
Lindsay Bliss ◽  
Christos Sidiropoulos
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Case Series ◽  
Long Term Outcomes ◽  
Pallidal Stimulation ◽  
Generalized Dystonia ◽  
Pallidal Deep Brain Stimulation ◽  
Deep Brain

Background. Dystonia is a ubiquitous syndrome, with a growing number of genes being continually identified. Mutations in the anoctamin-3 gene have been described to cause dystonia but the management and long-term outcomes are still largely unknown. Methods. We present here a long term, longitudinal follow up of a patient with generalized dystonia, who was treated with bilateral pallidal deep brain stimulation and was found to harbor a mutation in the anoctamin-3 gene. Results. Ongoing adjustment of stimulation settings and medications led to good and sustained dystonia control; however the patient did suffer short term relapses, manifested as dystonic crisis, which necessitated inpatient admission. Conclusion. This only the second patient to be reported with pallidal stimulation and an anoctamin-3 gene mutation. Long term outcomes seem to be favorable but larger case series are needed to confirm our findings.

Posttraumatic Peripherally-induced Dystonia and Multifocal Deep Brain Stimulation

Neurosurgery ◽  
2006 ◽  
Vol 59 (3) ◽  
pp. E702-E702 ◽  
Author(s):  
Hans-Holger Capelle ◽  
Eva Grips ◽  
Ralf Weigel ◽  
Christian Blahak ◽  
Baezner Hansjörg ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Globus Pallidus ◽  
Brain Stimulation ◽  
Motor Score ◽  
Computed Tomographic ◽  
Thalamic Stimulation ◽  
Pallidal Stimulation ◽  
History Of ◽  
Globus Pallidus Externus ◽  
Deep Brain

Abstract OBJECTIVE: We report on the effect of multifocal deep brain stimulation for the treatment of posttraumatic peripherally-induced dystonia. CLINICAL PRESENTATION: A 34-year-old woman presented with an 8-year history of painful tonic dystonia starting in her left leg after injury of the third metatarsal bone. She did not benefit from right-sided pallidal stimulation by an electrode misplaced in the globus pallidus externus in another hospital. INTERVENTION: Quadripolar deep brain stimulation electrodes were placed in the globus pallidus internus and the ventrolateral thalamus by computed tomographic-guided stereotactic surgery and microelectrode recording contralateral to the side of dystonia. The Burke-Fahn-Marsden motor score of 34 did not improve with chronic pallidal or thalamic stimulation. CONCLUSION: Although deep brain stimulation is received with great enthusiasm, it is important to identify its limitations in certain subtypes of dystonia.

Sign in / Sign up

Export Citation Format

Share Document