Bilateral deep brain stimulation of the subthalamic nucleus in primary Meige syndrome
| Autor: | Dianyou Li, Chunyan Cao, Wei Liu, Bomin Sun, Shikun Zhan, Jing Zhang, Peng Huang, Fafa Sun, Yixin Pan |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Deep brain stimulation medicine.medical_treatment Deep Brain Stimulation Stimulation 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Subthalamic Nucleus Medicine Humans Adverse effect Neurostimulation Aged Retrospective Studies Dystonia business.industry General Medicine Meige Syndrome Middle Aged medicine.disease Botulinum toxin Subthalamic nucleus Treatment Outcome Anesthesia Female business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Journal of neurosurgery. 128(3) |
| ISSN: | 1933-0693 |
| Popis: | OBJECTIVESubthalamic nucleus deep brain stimulation has been shown to be effective in reducing symptoms of primary Meige syndrome. However, assessments of its efficacy and safety have been limited to several case reports and small studies.METHODSThe authors performed a retrospective study to assess the efficacy and safety of bilateral subthalamic nucleus stimulation in 15 patients with primary Meige syndrome who responded poorly to medical treatments or botulinum toxin injections. Using the movement and disability subscores of the Burke-Fahn-Marsden Dystonia Rating Scale, the authors evaluated the severity of patients’ dystonia and related before surgery and at final follow-up during neurostimulation. The movement scale was assessed based on preoperative and postoperative video documentation by an independent rater who was unaware of each patient’s neurostimulation status. Quality of life was assessed with the Medical Outcomes Study 36-Item Short-Form General Health Survey.RESULTSThe dystonia movement subscores in 14 consecutive patients improved from 19.3 ± 7.6 (mean ± standard deviation) before surgery to 5.5 ± 4.5 at final follow-up (28.5 ± 16.5 months), with a mean improvement of 74% (p < 0.05). The disability subscore improved from 15.6 ± 4.9 before surgery to 6.1 ± 3.5 at final follow-up (p < 0.05). In addition, the postoperative SF-36 scores increased markedly over those at baseline. The authors also found that bilateral stimulation of the subthalamic nucleus immediately improved patient symptoms after stimulation and required lower stimulation parameters than those needed for pallidal deep brain stimulation for primary Meige syndrome. Four adverse events occurred in 3 patients; all of these events resolved without permanent sequelae.CONCLUSIONSThese findings provide further evidence to support the long-term efficacy and safety of subthalamic nucleus stimulation as an alternative treatment for patients with medically intractable Meige syndrome. |
| Databáze: | OpenAIRE |
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