Benefit of bilateral pallidotomy in the treatment of generalized dystonia

Lin, Juei Jueng; Lin, Ging Yau; Shih, Chunhsi; Lin, Shinn Zong; Chang, Dar Cheng; Lee, Chan Chian

doi:10.3171/jns.1999.90.5.0974

Cited by 53 publications

(25 citation statements)

References 12 publications

(23 reference statements)

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“…Single spectacular results of PVP were mainly observed in primary dystonia (Iacono et al, 1996;Lozano et al, 1997). However, in secondary dystonia the results are not always positive (Lin et al, 1999a(Lin et al, , 1999bKhan et al, 2000). Signi®cant improvement has been reported for dystonia in the setting of progressive neurodegeneration such as Hallervorden±Spatz (Justesen et al, 1999) or Huntington's disease (Cubo et al, 1999), but in one detailed case report, this improvement appeared to be modest (Cubo et al, 2000).…”

Section: Pallidotomy For Dystoniamentioning

confidence: 99%

“…In recent years, with the renaissance of PVP for PD, pallidotomy was also rediscovered in the treatment of generalized dystonia (Iacono et al, 1995;Lozano et al, 1997;Shima et al, 1997;Lenz et al, 1998;Lin et al, 1998Lin et al, , 1999aLin et al, , 1999bOndo et al, 1998;Vitek et al, 1998;. For dierent reasons (dystonic postures incompatible with the stereotactic frame, reduced ability of children to cooperate during surgery, questionable intraoperative eects of stimulation on dystonia), surgery was partly performed under general anesthesia Ondo et al, 1998).…”

Section: Pallidotomy For Dystoniamentioning

confidence: 99%

“…Mean maximal post-operative follow-up was 10.5 3.4 months for DYT1 positive, 7.5 5.8 for DYT1 negative primary dystonia, and 10.4 3.3 for secondary dystonia. Data are from the following references: Lozano et al, 1997;Ondo et al, 1998;Lin et al, 1998Lin et al, , 1999aLin et al, , 1999bKumar et al, 1999;Coubes et al, 2000c;Tronnier and Fogel, 2000;Vercueil et al, in press. so it was decided to switch o the stimulator. Because of the controlateral lesion, the patient did not recover to his pre-operative state (Cervera et al, 2000).…”

Section: Ablative Procedures Versus Dbsmentioning

confidence: 99%

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Mirthful laughter induced by subthalamic nucleus stimulation

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Copper salts, which are abundant, relatively inexpensive and possess low toxicity, have long been used as versatile catalysts for various reactions in organic synthesis. Recently, the development of Cu‐catalyzed or ‐mediated CH functionalization reactions has gained significant attention. Since the pioneering work of Daugulis on the introduction of 8‐aminoquinoline and picolinic acid auxiliaries as removable directing groups in transition metal‐catalyzed CH bond activations, the combination of copper salts with these bidentate directing groups has emerged as an innovative strategy for the construction of carbon‐carbon or carbon‐heteroatom bonds through CH bond cleavage. In addition to the 8‐aminoquinoline and picolinamide systems, several other bidentate directing groups including the 2‐aminophenyloxazoline group by Yu and Dai and the PIP system by Shi, have been developed as well. This review intends to cover most of the recent advances on copper‐catalyzed or ‐mediated direct sp2 and sp3 CH bond functionalizations assisted by these bidentate directing groups. The major achievements in this area are discussed and catalogued by the type of bonds formed (CC, CO, CN, CS, CP etc.). Special attention is paid to the reaction mechanisms. Selected examples of substrates are listed as well. In addition, a personal outlook is given at the end.

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Section: Pallidotomy For Dystoniamentioning

confidence: 99%

Section: Pallidotomy For Dystoniamentioning

confidence: 99%

Section: Ablative Procedures Versus Dbsmentioning

confidence: 99%

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Mirthful laughter induced by subthalamic nucleus stimulation

et al. 2001

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“…1 2 Pallidal surgery for dystonia has been reintroduced, and several studies with promising results have been published. [3][4][5][6][7] More recently, deep brain stimulation (DBS) through chronically implanted electrodes in the globus pallidus internus has gained increasing importance in the treatment of patients with medically intractable dystonia. [8][9][10][11] So far, however, most studies have reported only on relatively short follow up periods and are uncontrolled.…”

mentioning

confidence: 99%

Pallidal deep brain stimulation in patients with cervical dystonia and severe cervical dyskinesias with cervical myelopathy

Tj²,

Pohle

et al. 2002

Journal of Neurology, Neurosurgery &Amp; Psychiatry

192

103

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Objectives: Surgical treatment of complex cervical dystonia and of cervical dyskinesias associated with cervical myelopathy is challenging. In this prospective study, the long term effect of chronic pallidal stimulation in cervical dystonia and on combining the technique with spinal surgery in patients with severe cervical dyskinesias and secondary cervical myelopathy is described. Methods: Eight patients with a history of chronic dystonia who did not achieve adequate benefit from medical treatment or botulinum toxin injection participated in the study. Five patients had complex cervical dystonia with tonic postures and phasic movements. Three patients had rapidly progressive cervical myelopathy secondary to severe cervical dyskinesias and dystonia in the context of a generalised movement disorder. Quadripolar electrodes were implanted in the posteroventral lateral globus pallidus internus with stereotactic CT and microelectrode guidance. In the three patients with secondary cervical myelopathy, spinal surgery was performed within a few weeks and included multilevel laminectomies and a four level cervical corporectomy with spinal stabilisation. Results: Improvement of the movement disorder was noted early after pallidal surgery, but the full benefit could be appreciated only with a delay of several months during chronic stimulation. Three months after surgery, patients with cervical dystonia had improved by 38% in the severity score, by 54% in the disability score, and by 38% in the pain score of a modified version of the Toronto western spasmodic torticollis rating scale. At a mean follow up of 20 months, the severity score had improved by 63%, the disability score by 69%, and the pain score by 50% compared with preoperatively. There was also sustained amelioration of cervical dyskinesias in the three patients who underwent spinal surgery. Lead fractures occurred in two patients. The mean amplitude needed for chronic deep brain stimulation was 3.8 V at a mean pulse width of 210 µs, which is higher than that used for pallidal stimulation in Parkinson's disease. Conclusions: Chronic pallidal stimualtion is effective for complex cervical dystonia and it is a useful adjunct in patients with cervical dyskinesias and secondary cervical myelopathy who undergo spinal surgery.

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“…Soon after the renewed interest for pallidotomy in Parkinson's disease, this procedure was applied to dystonia patients as well, with remarkable results, although the total number of patients reported is small [17,40,71,79]. Most patients were treated with bilateral pallidotomy and a consistent finding has been that patients with primary dystonia respond remarkably well, whereas patients with secondary dystonia do not improve much.…”

Section: Pallidotomy In Generalized Dystoniamentioning

confidence: 63%

Surgical considerations in movement disorders: deep brain stimulation, ablation and transplantation

Schuurman

Bosch

Operative Neuromodulation

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SummarySurgical therapy for movement disorders has been practiced since the early 20th century, mostly for Parkinson's disease. At its onset, large destructive procedures like open resection of cortex, parts of the basal ganglia or its fibre connections produced variable, ill-documented results. With the introduction of the stereotactic operating technique in the second half of the century, ablative surgery became more refined, and more selective interventions became possible to alleviate the suffering of those patients for whom no other treatment modalities were yet available. However, the introduction of levodopa-based pharmacological therapy pushed surgical therapy almost completely to the background.In the past two decades, there has been a resurgence of interest in surgery for movement disorders, due to both limitations of long-term pharmacological therapy and the advent of the treatment modality of deep brain stimulation. The subject has now grown into a large field of clinical and scientific interest. Parkinson's disease is the most widespread surgical indication, but in other movement disorders considerable improvement can be achieved by surgery as well, most notably in dystonia. A short review of the surgical therapy for these disorders is presented.

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Benefit of bilateral pallidotomy in the treatment of generalized dystonia

Cited by 53 publications

References 12 publications

Mirthful laughter induced by subthalamic nucleus stimulation

Mirthful laughter induced by subthalamic nucleus stimulation

Pallidal deep brain stimulation in patients with cervical dystonia and severe cervical dyskinesias with cervical myelopathy

Surgical considerations in movement disorders: deep brain stimulation, ablation and transplantation

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