TY - JOUR
T1 - Neurosurgical treatment for dystonia
T2 - Long-term outcome in a case series of 80 patients
AU - Martínez, Jairo Alberto Espinoza
AU - Pinsker, Marcus O.
AU - Arango, Gabriel J.
AU - Garcia, Xiomara
AU - Oscar, Andrés Escobar V.
AU - Furlanetti, Luciano
AU - Reithmeier, Thomas
AU - Aranda, Iñigo Alonso Aguirre
AU - Marin, Jorge Humberto
AU - Lopez, William Omar Contreras
PY - 2014/8
Y1 - 2014/8
N2 - Introduction In this study, we assessed the outcomes of patients with dystonia who underwent surgery treatment following the same algorithm. Patients and methods Eighty consecutive patients with dystonia were submitted to neurosurgical management by means of intrathecal pump implantation, pallidotomy or deep brain stimulation (GPi or VIM). These patients included 48 patients with primary dystonia and 32 patients with secondary dystonia. Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) was used to access pre- and post-operative outcomes. Patients were followed from 12 to 114 months. Results Mean improvement in BFMDRS score among patients with PrD was 87.54% and 42.21% for SeD. Hemidystonic patients in both groups (PrD, SeD) showed a mean improvement in BFMDRS of 71.05% with GPiDBS. Patients with SeD due to previous perinatal insults showed a mean improvement in BFMDRS of 41.9%, with better results in purely dyskinetic patients (mean improvement of 61.2%). Conclusion Use of the proposed algorithm facilitated surgical decision planning, which translated in improved diagnostic rates, earlier interventions, appropriate management plans, and outcomes for both groups (PrD, SeD). Therefore, neuroimaging findings had a positive prognostic significance in the response to treatment in patients with primary dystonia compared with patients with secondary dystonia or distortion of basal ganglia anatomy. However, further studies in this line are warranted.
AB - Introduction In this study, we assessed the outcomes of patients with dystonia who underwent surgery treatment following the same algorithm. Patients and methods Eighty consecutive patients with dystonia were submitted to neurosurgical management by means of intrathecal pump implantation, pallidotomy or deep brain stimulation (GPi or VIM). These patients included 48 patients with primary dystonia and 32 patients with secondary dystonia. Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) was used to access pre- and post-operative outcomes. Patients were followed from 12 to 114 months. Results Mean improvement in BFMDRS score among patients with PrD was 87.54% and 42.21% for SeD. Hemidystonic patients in both groups (PrD, SeD) showed a mean improvement in BFMDRS of 71.05% with GPiDBS. Patients with SeD due to previous perinatal insults showed a mean improvement in BFMDRS of 41.9%, with better results in purely dyskinetic patients (mean improvement of 61.2%). Conclusion Use of the proposed algorithm facilitated surgical decision planning, which translated in improved diagnostic rates, earlier interventions, appropriate management plans, and outcomes for both groups (PrD, SeD). Therefore, neuroimaging findings had a positive prognostic significance in the response to treatment in patients with primary dystonia compared with patients with secondary dystonia or distortion of basal ganglia anatomy. However, further studies in this line are warranted.
KW - Burke-Fahn-Marsden Dystonia Rating Scale
KW - Deep brain stimulation
KW - Intrathecal baclofen therapy
KW - Primary dystonia
KW - Secondary dystonia
UR - http://www.scopus.com/inward/record.url?scp=84903841920&partnerID=8YFLogxK
U2 - 10.1016/j.clineuro.2014.05.012
DO - 10.1016/j.clineuro.2014.05.012
M3 - Artículo Científico
C2 - 24995965
AN - SCOPUS:84903841920
SN - 0303-8467
VL - 123
SP - 191
EP - 198
JO - Clinical Neurology and Neurosurgery
JF - Clinical Neurology and Neurosurgery
ER -