Specific movement and disability improvements in Burke-Fahn-Marsden Dystonia Rating Scale derived from pallidotomy in refractory patients to medical treatment
| Autor: | Juan Diego Vintimilla-Sarmiento, José D. Carrillo-Ruiz, Julián Eduardo Soto-Abraham, Gustavo Aguado-Carrillo, Francisco Velasco-Campos, José Luis Navarro-Olvera |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Internal capsule Pallidotomy medicine.medical_treatment Infarction Globus Pallidus Severity of Illness Index Disability Evaluation Young Adult Rating scale medicine Humans Dystonia business.industry General Medicine Middle Aged medicine.disease Magnetic Resonance Imaging Surgery Hemiparesis Treatment Outcome Dystonic Disorders Stereotaxic technique Etiology Female Neurology (clinical) medicine.symptom business |
| Zdroj: | Clinical neurology and neurosurgery. 210 |
| ISSN: | 1872-6968 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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