Document Detail

Low-voltage bilateral pallidal stimulation for severe meige syndrome in a patient with primary segmental dystonia: case report.
MedLine Citation:
PMID:  20729656     Owner:  NLM     Status:  MEDLINE    
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 microA. 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.
Luigi M Romito; Antonio E Elia; Angelo Franzini; Orso Bugiani; Alberto Albanese
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  67     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-23     Completed Date:  2010-12-13     Revised Date:  2011-08-25    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  onsE308; discussion onsE308     Citation Subset:  IM    
Department of Neurology, Fondazione I.R.C.C.S. Istituto Neurologico Carlo Besta, Università Cattolica del Sacro Cuore, Milan, Italy.
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MeSH Terms
Biophysics / methods
Deep Brain Stimulation / methods*
Dystonic Disorders / complications
Electrodes, Implanted
Globus Pallidus / physiology*
Longitudinal Studies
Magnetic Resonance Imaging / methods
Meige Syndrome / etiology,  therapy*
Middle Aged
Treatment Outcome

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

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