Document Detail


Restoration of erect posture by deep brain stimulation of the globus pallidus in disabling dystonic spinal hyperextension.
MedLine Citation:
PMID:  19943733     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Dystonia is a movement disorder notoriously difficult to treat. While primary dystonia is classically considered to respond well to deep brain stimulation (DBS), treatment of secondary dystonia yields variable results. Patient selection should be done on a case-by-case basis. Clearly, there is a need to accumulate additional information with regard to prognostic factors that may aid neurosurgeons in selecting those patients in whom the disorder is most likely to respond favorably to pallidal DBS. The authors report the case of a 29-year-old man with secondary dystonia due to perinatal hypoxia. The most prominent symptom was what we have termed ectatocormia-that is, severe, fixed truncal hyperextension and retrocollis, exacerbated by phasic, twisting movements of the trunk and head. This made it impossible for the patient to maintain a normal upright posture or to walk. The patient underwent bilateral DBS of the globus pallidus internus (GPi), and the authors observed impressive improvement in motor abilities and function. The patient's body adopted the normal upright posture and he became able to walk again, 4 months after the commencement of GPi stimulation. This report, along with others, emphasizes that the GPi as an ideal target for alleviating axial tonic symptoms. The presence of normal MR imaging findings, a phenotypical purity of predominantly dystonic symptoms, and a younger age seem to favor a positive outcome.
Authors:
Damianos E Sakas; Lampis C Stavrinou; Efstathios J Boviatsis; Pantelis Stathis; Marios Themistocleous; Stylianos Gatzonis
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  112     ISSN:  1933-0693     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-02     Completed Date:  2010-06-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1279-82     Citation Subset:  AIM; IM    
Affiliation:
Unit of Functional Neurosurgery, Department of Neurosurgery, University of Athens, Evangelismos Hospital, Athens, Greece. sakasde@med.uoa.gr
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MeSH Terms
Descriptor/Qualifier:
Adult
Asphyxia Neonatorum / complications
Deep Brain Stimulation / methods*
Dystonia Musculorum Deformans / physiopathology,  therapy*
Follow-Up Studies
Globus Pallidus / physiopathology*
Humans
Infant, Newborn
Male
Motor Skills / physiology
Postural Balance / physiology
Posture / physiology*
Walking / physiology

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


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