Document Detail


Chronic stimulation of the globus pallidus internus for control of primary generalized dystonia.
MedLine Citation:
PMID:  14518538     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Our experience of deep brain stimulation of the globus pallidus internus (GPi-DBS) for dystonia is summarized. A total of 5 patients with primary generalized dystonia underwent GPi-DBS. There were 3 males and 2 females. The age at onset of dystonia ranged from 8 to 45 years and the age at surgery for GPi-DBS ranged from 17 to 59 years. Two of the patients had been treated previously by bilateral thalamotomy or unilateral pallidotomy at other clinics and then developed new symptoms or recurrence. All were stimulated bilaterally. No surgical complications were encountered. The symptoms of dystonia were scored by the Burke-Fahn-Marsden dystonia rating scale (BFMDRS). The scores ranged from 18 to 62 before surgery. An improvement in the symptoms of dystonia was observed soon after the initiation of GPi-DBS, and additional progressive improvement was noted during a period of months or even years after surgery. The score at 6 months after surgery reached a level ranging from 4 to 23. The improvement in score ranged from -51% to -92%. GPi-DBS produced a marked effect even in patients who had previously undergone thalamotomy or pallidotomy. At 6 months after surgery, all patients were receiving bipolar stimulation with a wide interpolar distance, using contact 0 or 1 as the cathode and contact 2 or 3 as the anode. Stimulation was being performed at an intensity of around 2.0 V with a pulse width of 0.21 ms at a high frequency ranging from 120 to 140 Hz. GPi-DBS represents an important therapeutic option in many patients with primary generalized dystonia.
Authors:
Y Katayama; C Fukaya; K Kobayashi; H Oshima; T Yamamoto
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Acta neurochirurgica. Supplement     Volume:  87     ISSN:  0065-1419     ISO Abbreviation:  Acta Neurochir. Suppl.     Publication Date:  2003  
Date Detail:
Created Date:  2003-10-01     Completed Date:  2003-10-30     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100962752     Medline TA:  Acta Neurochir Suppl     Country:  Austria    
Other Details:
Languages:  eng     Pagination:  125-8     Citation Subset:  IM    
Affiliation:
Department of Neurological Surgery and Division of Applied System Neuroscience, Nihon University School of Medicine, Tokyo, Japan. ykatayam@med.nihon-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Child
Dystonic Disorders / diagnosis,  rehabilitation*,  surgery
Electric Stimulation Therapy / methods*
Electrodes, Implanted
Female
Follow-Up Studies
Globus Pallidus*
Humans
Male
Middle Aged
Postoperative Care
Preoperative Care
Recurrence
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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