Acute onset dystonic camptocormia caused by lenticular lesions

Nieves, Anette; Miyasaki, Janis; Lang, Anthony E.

doi:10.1002/1531-8257(200101)16:1<177::aid-mds1035>3.0.co;2-c

Cited by 58 publications

(34 citation statements)

References 16 publications

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“…Although the exact location of these cerebral alterations is still unknown, reports of camptocormia caused by lenticular ischemic lesions [22] support the idea that dysfunction of the basal ganglia plays a role in its pathogenesis. Except in these sporadic observations, in which MRI depicted foci of T2 high signal intensity in the putamen or caudate nuclei [9,10,22], conventional MRI of the brain has not revealed any significant abnormalities in patients with camptocormia associated with PD [12,17].…”

Section: Introductionmentioning

confidence: 96%

“…Except in these sporadic observations, in which MRI depicted foci of T2 high signal intensity in the putamen or caudate nuclei [9,10,22], conventional MRI of the brain has not revealed any significant abnormalities in patients with camptocormia associated with PD [12,17]. However, no dedicated MRI study assessed either the load of cerebral ischemic lesions or the global or segmented cerebral atrophy in patients with camptocormia.…”

Section: Introductionmentioning

confidence: 98%

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Camptocormia and Parkinson’s disease: MR imaging

et al. 2008

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Camptocormia is characterized by an excessive anterior flexion of the spine that appears only when standing or walking. The origin of this symptom remains unknown, but recent clinical reports of camptocormia associated with Parkinson's disease (PD) suggest cerebral involvement in the pathogenesis of camptocormia. This study was undertaken to investigate the hypothesis that camptocormia in PD has a central origin. Seventeen PD patients with camptocormia were prospectively enrolled and were compared to 10 matched PD patients without camptocormia and 12 normal controls. The normalized volumes of the brain, striatal nuclei, and the cross-sectional areas of the midbrain and pons were measured on three-dimensional magnetic resonance imaging. Data were correlated with the severity of the symptoms. The normalized axial surface of the midbrain was statistically smaller in PD patients with camptocormia than in normal controls (P = 0.01). The normalized volumetric data were not statistically different in PD patients with camptocormia. There was a significant negative correlation between the severity of camptocormia and the normalized brain volume (P < 0.009; R = -0.649) and sagittal pons area (P < 0.01; R = -0.642). The results suggest that PD with camptocormia may represent a selective form of PD in which a specific neuronal dysfunction possibly occurs within the brainstem.

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Section: Introductionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 98%

Camptocormia and Parkinson’s disease: MR imaging

et al. 2008

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“…This theory is supported by electromyographic findings of dystonic discharges from paraspinal muscles and anecdotal reports of clinical improvement after DBS [26]. In addition, acute onset dystonic camptocormia has been associated with lenticular lesions, suggesting that the basal ganglia play an important role in the maintenance of axial posture [27]. The second theory hypothesizes that camptocormia is primarily a muscle problem affecting trunk extension, and therefore a peripheral disorder [28].…”

Section: Camptocormia (Bent Spine)mentioning

confidence: 90%

Orthopedic Complications of Parkinson's Disease

Rudolph

Tagliati

2011

Parkinson's Disease

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“…More recently, camptocormia has been found to be associated with other neurological disorders, including idiopathic Parkinson's disease (PD) (13,14,27,32). Medical treatments of the condition have generally been ineffective.…”

Section: öZmentioning

confidence: 99%

“…In addition, acute onset camptocormia was reported associated with lenticular lesions and the possible role of the striatum and pallidum in maintaining axial posture (14). With the well-documented success of pallidotomy and GPi DBS for dystonia, the GPi makes an attractive target for patients with camptocormia (9,28,29).…”

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confidence: 99%

Long-term benefit of bilateral subthalamic deep brain stimulation on camptocormia in parkinson’s disease

Lyons¹,

Boucher²,

Patel³

et al. 2010

Turkish Neurosurgery

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We report the case of a 63-year-old female with a long history of severe Parkinson's disease (PD) and subsequent onset of debilitating camptocormia who underwent successful bilateral subthalamic nucleus deep brain stimulation surgery (STN DBS). The literature and previous reports are reviewed. The patient history and details of the surgical procedure are reported including the implantable pulse generator (IPG) settings and response to stimulation. The results of her PD symptom and camptocormia improvements are discussed. Five year postoperatively, the patient has enjoyed good results for both her PD symptoms as well as significant and sustained improvement in her thoracolumbar flexion deformity. She remains on minimal medications and no longer requires any assistive devices for ambulation. Comparison and contrast of the current world literature on DBS for camptocormia is reviewed. We discuss the current targets used for DBS in the setting of camptocormia in the cases reported, both PD associated and not associated. The optimal target has yet to be defined and further work on appropriate patient selection is needed. ÖZUzun süredir şiddetli Parkinson hastalığı (PH) ve yakın zamanda maluliyete neden olan kamptokormisi olan ve bilateral subtalamik nükleus derin beyin stimülasyon cerrahisinin (STN DBS) başarıyla yapıldığı 63 yaşında bir kadın hastayı sunuyoruz. Literatür ve önceki raporlar gözden geçirilmektedir. Hasta öyküsü ve implante edilen puls jeneratörü (IPG) ayarları ve stimülasyona cevap dahil olmak üzere cerrahi işlem ayrıntıları bildirilmiştir. PD belirtilerinin sonuçları ve kamptokormideki gelişmeler anlatılmaktadır. Ameliyattan beş yıl sonra hasta halen PD belirtileri açısından iyi sonuçlar ve torakolumbar fleksiyon deformitesinde önemli ve uzun süreli iyileşme mevcuttu. Hasta çok az sayıda ilaç kullanmakta ve artık ambulasyon için yardımcı cihazlara gereksinim duymamaktadır. Kamptokormi için DBS konusunda mevcut dünya literatürü bilgileri karşılaştırılmış ve değerlendirilmektedir. Bildirilen vakalarda PD ile ilişkili olsun veya olmasın kamptokormi durumunda DBS için kullanılan mevcut hedefleri gözden geçiriyoruz. Optimum hedefin halen tanımlanması gerekmektedir ve uygun hasta seçimi açısından hâlâ yapılması gerekenler vardır.

show abstract

Acute onset dystonic camptocormia caused by lenticular lesions

Cited by 58 publications

References 16 publications

Camptocormia and Parkinson’s disease: MR imaging

Camptocormia and Parkinson’s disease: MR imaging

Orthopedic Complications of Parkinson's Disease

Long-term benefit of bilateral subthalamic deep brain stimulation on camptocormia in parkinson’s disease

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