Bilateral pallidal deep brain stimulation in idiopathic dystonic camptocormia

Yadav, Ravi; Ansari, Abu Zafar; Surathi, Pratibha; Srinivas, Dwarakanath; Somanna, Sampath; Pal, Pramod Kumar

doi:10.4103/0028-3886.170080

Cited by 6 publications

(3 citation statements)

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“…опубликовали результаты лечения дистонии с помощью глубинной стимуляции медиальной части бледного шара. Авторы отметили снижение выраженности дистонии в туловище и конечностях на 50%, а в шее -более чем на 90% [43]. Существующее мнение, согласно которому у пациентов после глубинной стимуляции происходит нарушение психики, было опровергнуто исследованием S. Meoni и соавт.…”

Section: дистонияunclassified

“…Иллюстрация опыта, где нападающий бык останавливается (а) и поворачивает в противоположную сторону (б). Эссенциальный тремор Вентральное промежуточное ядро таламуса, субталамическое ядро, zona incerta, prelemniscal radiation [30][31][32][33][34][35][36][37] Дистония Внутренняя часть бледного шара, вентральное промежуточное и вентральное заднее ядро таламуса, субталамическое ядро [38][39][40][41][42][43][44] Детский церебральный паралич Вентролатеральное ядро таламуса, медиальная часть бледного шара, верхние ножки мозжечка [45][46][47][48][49][50] Болезнь Туретта Медиальные таламические ядра, бледный шар [51][52][53] Х. Дельгадо занимался проблемой лечения эпилепсии, болезни Паркинсона, психических расстройств; изобрел устройства, напоминающие нимб и шлем, через которые электромагнитные импульсы раздражали различные участки головного мозга.…”

Section: Introductionunclassified

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Deep stimulation in neurosurgery

Kalinkin

Александрович²,

Vinokurov

et al. 2019

Journal of Clinical Practice

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Section: дистонияunclassified

Section: Introductionunclassified

Deep stimulation in neurosurgery

Kalinkin

Александрович²,

Vinokurov

et al. 2019

Journal of Clinical Practice

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“…Beneficial effects have been reported in patients with segmental or abdominal dystonia with dystonic findings in the EMG after treatment with BTX injections in the upper abdominal muscles or the rectus abdominis [89, 154]. However, BTX injections in abdominal dystonia were ineffective in two cases [6], or had only partial effects [155]. …”

Section: Treatment Options For Camptocormiamentioning

confidence: 99%

Pathophysiological Concepts and Treatment of Camptocormia

Margraf

Wrede

Deuschl

et al. 2016

JPD

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Camptocormia is a disabling pathological, non-fixed, forward bending of the trunk. The clinical definition using only the bending angle is insufficient; it should include the subjectively perceived inability to stand upright, occurrence of back pain, typical individual complaints, and need for walking aids and compensatory signs (e.g. back-swept wing sign). Due to the heterogeneous etiologies of camptocormia a broad diagnostic approach is necessary. Camptocormia is most frequently encountered in movement disorders (PD and dystonia) and muscles diseases (myositis and myopathy, mainly facio-scapulo-humeral muscular dystrophy (FSHD)). The main diagnostic aim is to discover the etiology by looking for signs of the underlying disease in the neurological examination, EMG, muscle MRI and possibly biopsy. PD and probably myositic camptocormia can be divided into an acute and a chronic stage according to the duration of camptocormia and the findings in the short time inversion recovery (STIR) and T1 sequences of paravertebral muscle MRI. There is no established treatment of camptocormia resulting from any etiology. Case series suggest that deep brain stimulation (DBS) of the subthalamic nucleus (STN-DBS) is effective in the acute but not the chronic stage of PD camptocormia. In chronic stages with degenerated muscles, treatment options are limited to orthoses, walking aids, physiotherapy and pain therapy. In acute myositic camptocormia an escalation strategy with different immunosuppressive drugs is recommended. In dystonic camptocormia, as in dystonia in general, case reports have shown botulinum toxin and DBS of the globus pallidus internus (GPi-DBS) to be effective. Camptocormia in connection with primary myopathies should be treated according to the underlying illness.

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Effects of Deep Brain Stimulation on Postural Trunk Deformities: A Systematic Review

Lizárraga

Fasano

2019

Movement Disord Clin Pract

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Background Deep brain stimulation (DBS) effects on postural deformities are still poorly explored. Methods Systematic review in accord with the Preferred Reporting Items for Systematic review and Meta‐Analysis guidelines (PRISMA). Results All 38 studies that met predefined eligibility criteria had high risk of bias attributed to retrospective analysis of heterogeneous populations with variable and incompletely reported demographic and clinical characteristics, definitions, outcomes, DBS indications, targets, and settings. Five patient groups were identified in the 35 studies with individual data available: (1) parkinsonian camptocormia (n = 96): 89 patients underwent subthalamic (STN) and 7 globus pallidus pars interna (GPi) DBS. Camptocormia was the indication in 3 patients. After DBS, camptocormia improved in 57 of 96 patients (4.3–100% improvement) and remained stable or worsened in 39 of 96 patients (2–100% worsening). (2) dystonic camptocormia (n = 16): All underwent GPi‐DBS. They were younger and with shorter disease duration, but longer deformity duration, compared with parkinsonian camptocormia. After GPi‐DBS, camptocormia improved in all patients (50–100% improvement). (3) Parkinsonian Pisa syndrome (n = 14): 11 patients underwent STN‐DBS for motor fluctuations whereas Pisa syndrome was the indication for pedunculopontine and GPi‐DBS in 2 patients. After DBS, Pisa improved in 10 of 14 patients (33.3–66.7% improvement). (4) Dystonic opisthotonus: 2 young patients remarkably responded to GPi‐DBS. (5) Parkinsonian anterocollis: There were variable responses in 3 patients after STN‐DBS for motor fluctuations. Conclusions Low‐quality level of evidence suggests that dystonic camptocormia and opisthotonus improve after GPi‐DBS. Parkinsonian camptocormia, Pisa syndrome, and anterocollis have variable responses, and their dystonic features should be further explored.

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Bilateral pallidal deep brain stimulation in idiopathic dystonic camptocormia

Abstract: In this report, we have shown the efficacy of GPi DBS in the treatment of drug refractory dystonia associated camptocormia. Although only reported for PD associated camptocormia, evaluation for truncal extensor myopathy is mandatory in these cases also to achieve a good outcome.

Cited by 6 publications

References 1 publication

Deep stimulation in neurosurgery

Deep stimulation in neurosurgery

Pathophysiological Concepts and Treatment of Camptocormia

Effects of Deep Brain Stimulation on Postural Trunk Deformities: A Systematic Review

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