Treatment of Hemichoreoathetosis with Arrhythmic Proximal Tremor after Stroke: The Role of Zona Incerta as a Target for Deep Brain Stimulation.

Autor:	Koerbel A; Department of Neurosurgery, University of Joinville Region, and Neurological and Neurosurgical Clinic of Joinville, Joinville, Brazil., Amaral ARD; Department of Neurosurgery, University of Joinville Region, Joinville, Brazil, Zeh HB; Department of Neurosurgery, University of Joinville Region, Joinville, Brazil, Wollmann E; Department of Neurosurgery, University of Joinville Region, Joinville, Brazil, Koerbel RFH; Intraoperative Monitoring, Neurological and Neurosurgical Clinic of Joinville, Joinville, Brazil, Moro C; Department of Neurology, Neurological and Neurosurgical Clinic of Joinville, Joinville, Brazil, Longo AL; Department of Neurology, Neurological and Neurosurgical Clinic of Joinville, Joinville, Brazil
Jazyk:	angličtina
Zdroj:	Journal of movement disorders [J Mov Disord] 2019 Jan; Vol. 12 (1), pp. 47-51. Date of Electronic Publication: 2019 Jan 30.
DOI:	10.14802/jmd.18032
Abstrakt:	Deep brain stimulation (DBS) of the zona incerta has shown promising results in the reduction of medically refractory movement disorders. However, evidence supporting its efficacy in movement disorders secondary to hemorrhagic stroke or hemichoreoathetosis is limited. We describe a 48-year-old man who developed progressive hemichoreoathetosis with an arrhythmic, proximal tremor in his right arm following a thalamic hemorrhagic stroke. Pharmacological treatment was carried out with no change in the Abnormal Involuntary Movement Scale (AIMS) score after 4 weeks (14). After six sessions of botulinum toxin treatment, a subtle improvement in the AIMS score (13) was registered, but no clinical improvement was noted. The arrhythmic proximal movements were significantly improved after DBS of the zona incerta with a major decrease in the patient's AIMS score (8). The response to DBS occurring after the failure of pharmacological and botulinum toxin treatments suggests that zona incerta DBS may be an alternative for postthalamic hemorrhage movement disorders.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu