Full recovery from drummer’s dystonia with foot and arm symptoms after stereotactic ventro-oral thalamotomy: a case report

Asahi, Takashi; Taira, Takaomi; Ikeda, Kiyonobu; Yamamoto, Jiro; Sato, Shuji

doi:10.1007/s00701-018-3480-5

Cited by 11 publications

(5 citation statements)

References 23 publications

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“…This may indicate that sufficient lesioning of both the Vo nuclei, which are around 6–7 mm in size, is necessary to achieve a successful outcome. The coagulative lesions created in this current study, which covered both the Vop and Voa, appeared to be larger in size as compared to those in previous reports ( 12 – 18 ), yet, none of the patients suffered from any permanent complication. Considering that care should be taken to avoid direct injury to the internal capsule or other surrounding structures, intraoperative tests conducted with stimulating electrodes are necessary prior to the lesioning, as described above.…”

Section: Resultscontrasting

confidence: 66%

“…More than two decades ago, we first applied selective Vo thalamotomy as a treatment option for dystonic writer's cramp ( 11 ). Ever since, multiple reports have further shown that stereotactic ablation ( 12 – 18 ) or deep brain stimulation (DBS) ( 19 – 21 ) of the Vo nucleus is a successful therapy for patients with various types of FHD. By evaluating a single center case series, we here introduced the use of stereotactic lesioning of the thalamic Vo nucleus for the treatment of writer's cramp.…”

Section: Introductionmentioning

confidence: 99%

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Stereotactic Lesioning of the Thalamic Vo Nucleus for the Treatment of Writer's Cramp (Focal Hand Dystonia)

et al. 2018

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Writer's cramp (focal hand dystonia) is a sporadic focal dystonia that affects a specific part of the upper limb causing excessive co-contraction of antagonistic muscles. It usually presents as a task-specific dystonia, including, among others, writing of a character or playing a musical instrument. Although treatments for writer's cramp exist, medical therapy often results in unsatisfactory outcomes in patients with this type of dystonia. However, accumulating evidence suggests that long-term and complete remission of various types of focal hand dystonia can be achieved with stereotactic ablation or deep brain stimulation of the thalamic ventral-oralis complex (Vo) nucleus, which includes both the ventralis oralis posterior and anterior nuclei of the thalamus. Following the striking therapeutic success of Vo thalamotomy in patients with medically-refractory writer's cramp, we here introduce the use of stereotactic lesioning of the thalamic Vo nucleus for the treatment of this focal type of dystonia. Our findings identified patients with disabling writer's cramp (i.e., it prevents their success in their professional careers) to be good candidates for positive outcome with this surgical technique.

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Section: Resultscontrasting

confidence: 66%

Section: Introductionmentioning

confidence: 99%

Stereotactic Lesioning of the Thalamic Vo Nucleus for the Treatment of Writer's Cramp (Focal Hand Dystonia)

et al. 2018

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“…Douglas et al believed that ADCY5 mutations should be considered in the presence of overt myoclonic dystonia and that ADCY5-related dyskinesia may manifest differently in a family [ 3 ]. Asahi et al believed that abdominal thalamotomy is effective in patients with focal task-specific dystonia, but only in patients with upper extremity symptoms [ 4 ]. However, the limitations of the above studies are large, and the clinical effects of botulinum toxin injections on focal dystonia and muscle spasm were tested.…”

Section: Related Workmentioning

confidence: 99%

Clinical Observation of Botulinum Toxin Injection in the Treatment of Focal Dystonia and Muscle Spasm

Zhang

2022

BioMed Research International

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Dystonia and muscle spasms are a group of common and unfavorable clinical neurological symptoms. The use of botulinum toxin (BTX-A) abroad has achieved good results in the treatment of various movement disorders characterized by involuntary or abnormal muscle contractions. It is expected to open up a new field for the treatment of myelodysplastic syndromes (MDs) such as focal dystonia and muscle spasm. There are theoretical and practical implications for the diagnosis and development of some effective neurological treatments. The efficacy of BTX-A in the treatment of various focal dystonia and muscle spasm disorders is as follows: symptoms were improved to varying degrees after injection of Botox or botulinum toxin type A (CBTX-A), but Botox or CBTx. There was no significant difference in the efficacy of A. 30.4% of patients had complete remission, 57.8% had significant remission, and 8.9% had partial remission. Among them, HFS and BS had the best curative effect, and the symptoms were significantly improved by 95.3% and 89.4%, respectively. The efficacy of CD was also satisfactory, with 75.5% of the patients showing significant improvement in symptoms, followed by Meg/OMD (OMD) with 73.3% and SD with 3.3%. The efficacy of WC is poor, and functional improvement is uncertain. Other forms of focal dystonia and spasticity also showed significant functional improvement in 60% of patients. Most patients start to see effects within 1 week after BTX-A injection, symptoms gradually improve, and the bridge of curative effect is reached in 2-4 weeks, and the healing effect lasts for about 3-5 months on average. The overall severity of adverse effects was not severe and resolved spontaneously within a few days to ten weeks, with the most concerning complications being ptosis and dysphagia.

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“…В статье описан случай успешного проведения таламотомии с помощью ФУЗ в лечении дистонии музыканта. Хирургическое лечение методом стереотаксической деструкции в таких случаях сравнительно редко используется и представлено ограниченной доказательной базой [8][9][10][11][12][13] (табл. 2).…”

Section: Discussionunclassified

Thalamotomy with focused ultrasound in the treatment of musician’s dystonia

Dzhafarov,

Kholyavin,

Amelin

et al. 2023

Nejrohirurgiâ (Mosk.)

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Background. Approximately from 0.5 to 8 % professional musicians may suffer from focal dystonia. Stereotactic surgery is option if conservative therapy is failed. Thalamotomy has been reported in limited series in the world literature.Aim. To demonstrate a clinical case of thalamotomy with focused ultrasound in a professional guitarist with focal dystonia of the hand.Materials and methods. A 40‑year‑old patient suffered from spasms of the fingers while playing the guitar since 2009. Patient lost professional skills and changed his activities due to progression and severity of disease. He visited our clinic for surgical treatment, stereotactic ventro‑oral thalamotomy by transcranial focused ultrasound was considered.Results. Thalamotomy provided complete reduction of dystonia without complications. On the 2nd day after the procedure, the patient discharged. In a week mild dysarthria was noticed, which did not affect daily activities and completely regressed within a month. A month later, the patient was able to return to concert performance. The follow‑up period was 6 months with no symptoms of the disease.Conclusion. Successful clinical case of focused ultrasound thalamotomy in patient with musician’s dystonia is presented.

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Full recovery from drummer’s dystonia with foot and arm symptoms after stereotactic ventro-oral thalamotomy: a case report

Cited by 11 publications

References 23 publications

Stereotactic Lesioning of the Thalamic Vo Nucleus for the Treatment of Writer's Cramp (Focal Hand Dystonia)

Stereotactic Lesioning of the Thalamic Vo Nucleus for the Treatment of Writer's Cramp (Focal Hand Dystonia)

Clinical Observation of Botulinum Toxin Injection in the Treatment of Focal Dystonia and Muscle Spasm

Thalamotomy with focused ultrasound in the treatment of musician’s dystonia

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