Choreo-ballistic movement after thalamotomy in a patient with Lewy body dementia
| Autor: | Yuto Suzuki, Rei Enatsu, Mayumi Kitagawa, Takuro Saitoh, Takashi Morishita, Takeshi Mikami, Nobuhiro Mikuni |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Lewy Body Disease
medicine.medical_specialty medicine.medical_treatment 03 medical and health sciences 0302 clinical medicine Postoperative Complications Thalamus Chorea Physiology (medical) medicine Paralysis Dementia Humans Aged Lewy body Thalamotomy business.industry Sensory loss General Medicine medicine.disease Hand Dysphagia Surgery Psychosurgery Subthalamic nucleus Neurology 030220 oncology & carcinogenesis Female Neurology (clinical) medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia. 66 |
| ISSN: | 1532-2653 |
| Popis: | Thalamotomy is an established treatment for medically refractory tremor. Major complications of thalamotomy include cognitive disturbance, paralysis, dysphagia, sensory loss, and speech disturbance. Hemiballism is a rare complication after thalamotomy. We herein present a 74-year-old female patient who developed choreo-ballistic movement after thalamotomy. She was diagnosed with Lewy body dementia at the age of 70 years and exhibited worsening bilateral hand tremor. Her tremor was severe and pharmacoresistant. Left thalamotomy was planned with the trajectory passing through the ventralis intermedius (VIM) nucleus to the posterior subthalamic area (PSA). The right VIM nucleus and PSA were both coagulated with one trajectory, resulting in the immediate amelioration of right hand tremor. However, four days after surgery, choreo-ballistic movement appeared in the right leg and persisted for six months. Furthermore, tremor recurred after one month. Postoperative MRI showed a small coagulated lesion in the subthalamic nucleus. Although choreo-ballistic movement is a rare complication, it needs to be considered, particularly in patients in which the inferior border of the VIM nucleus is targeted. |
| Databáze: | OpenAIRE |
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