Specific movement and disability improvements in Burke-Fahn-Marsden Dystonia Rating Scale derived from pallidotomy in refractory patients to medical treatment.

Autor: Vintimilla-Sarmiento JD; Unit for Stereotactic and Functional Neurosurgery, Mexico General Hospital, Mexico City, Mexico. Electronic address: drvinti1987@gmail.com., Carrillo-Ruiz JD; Unit for Stereotactic and Functional Neurosurgery, Mexico General Hospital, Mexico City, Mexico., Navarro-Olvera JL; Unit for Stereotactic and Functional Neurosurgery, Mexico General Hospital, Mexico City, Mexico., Aguado-Carrillo G; Unit for Stereotactic and Functional Neurosurgery, Mexico General Hospital, Mexico City, Mexico., Soto-Abraham JE; Unit for Stereotactic and Functional Neurosurgery, Mexico General Hospital, Mexico City, Mexico., Velasco-Campos FJ; Unit for Stereotactic and Functional Neurosurgery, Mexico General Hospital, Mexico City, Mexico.
Jazyk: angličtina
Zdroj: Clinical neurology and neurosurgery [Clin Neurol Neurosurg] 2021 Nov; Vol. 210, pp. 106955. Date of Electronic Publication: 2021 Sep 17.
DOI: 10.1016/j.clineuro.2021.106955
Abstrakt: Background: Dystonia is a movement disorder associated with significant disability and is usually refractory to medical treatment. Pallidotomy may decrease dystonic movements. The aim of this study was to quantify movement and disability improvements through Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS).
Methods: We carried out a longitudinal clinical study in patients with refractory primary and secondary dystonia, who underwent radiofrequency (RF) unilateral and bilateral lesions on the postero-ventro-lateral globus pallidus internus (GPi), evaluating the outcomes through BFMDRS and variables as age, time of evolution, etiology, body distribution, planned target coordinates, and lesion size, during a mean follow-up time of 35.67 months.
Results: Nine RF pallidotomies were performed on 6 patients, 7 right-sided and 2 left-sided; three patients were treated unilaterally for one occasion, while the others underwent 2 surgeries, including one staged bilateral procedure. Mean BFMDRS scores for movement were 38.5 preoperative and 25.5 postoperative, and for disability were 20.4 preoperative and 17.3 postoperative. We noticed improvement in movement (32.54%, p = 0.001) and disability (17.23%, p = 0.002). There was one right GPi and internal capsule (IC) infarction with contralateral hemiparesis as sequelae.
Conclusions: RF pallidotomy is an effective and accessible procedure to reduce BFMDRS scores in refractory dystonia if patients are correctly selected by severity, evolution, and disability as determining factors.
(Copyright © 2021 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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