Tiefe Hirnstimulation bei Morbus Parkinson mit Kamptokormie? Ein Fallbericht
| Autor: | Coenen Va, Miskiewicz Aa, Allert N |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
medicine.medical_specialty
Parkinson's disease Deep brain stimulation Axial dystonia business.industry medicine.medical_treatment Disease medicine.disease nervous system diseases Psychiatry and Mental health Subthalamic nucleus Camptocormia surgical procedures operative Physical medicine and rehabilitation nervous system Neurology Basal ganglia medicine Neurology (clinical) medicine.symptom Myopathy business Neuroscience |
| Zdroj: | Fortschritte der Neurologie · Psychiatrie. 79:97-101 |
| ISSN: | 1439-3522 0720-4299 |
| DOI: | 10.1055/s-0029-1245994 |
| Popis: | Camptocormia is recognised as a severe postural movement disorder complicating neurodegenerative diseases like Parkinson's disease (PD) and multisystem atrophy. Pathophysiologically two main hypotheses are discussed: (i) a disorder of the basal ganglia resulting in axial dystonia and rigidity on the one hand and (ii) an extensor truncal myopathy on the other hand. Therapeutic efforts often result in limited success. Therefore, reports on improvements by deep brain stimulation (DBS) are of great interest. However, the role of DBS in the treatment of camptocormia remains unclear. Here, we report a female PD patient who responded well to DBS of the subthalamic nucleus for severe dyskinesias and fluctuations. However, after 6 months she started to develop a rapidly progressing camptocormia which did not respond to DBS. The clinical and electrophysiological examination suggested a truncal erector myopathy. The inconsistent reports on the effects of DBS on camptocormia in PD patients suggest heterogeneous pathogenetic pathways. A pathophysiological subtype with predominant basal ganglia dysfunction and responsivity to DBS, however, seems to be rather rare. A myopathy, in contrast, seems to be more frequent and DBS is not effective in this condition. Therefore, camptocormia in PD patients is not an established indication for DBS. |
| Databáze: | OpenAIRE |
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