Bilateral pallidotomy for generalized dystonia
Arq. neuropsiquiatr
;
59(2B): 353-357, Jun. 2001. tab
Artigo
em Inglês
| LILACS
| ID: lil-286415
ABSTRACT
OBJECTIVE:
To evaluate the efficacy and safety of bilateral pallidotomies in five patients with generalized dystonia.BACKGROUND:
Generalized dystonias are frequently a therapeutic challenge, with poor responses to pharmacological treatment. GPi (globus pallidus internus) pallidotomies for Parkinson's disease ameliorate all kinds of dyskinesias/dystonia, and recent studies reported a marked improvement of refractory dystonias with this procedure.METHODS:
Five patients with generalized dystonias refractory to medical treatment were selected; one posttraumatic and four idiopathic. The decision to perform bilateral procedures was based on the predominant axial involvement in these patients. Dystonia severity was assessed with the Burke-Fahn-Marsden Dystonia Scale (BFM). Simultaneous procedures were performed in all but one patient, who had a staged procedure. They were reevaluated with the same scale (BFM) by an unblinded rater at 1, 2, 3, 30, 60, 90, 120 and 180 days post-operatively.RESULTS:
The four patients with idiopathic dystonia showed a progressive improvement up to three months; the patient with posttraumatic dystonia relapsed at three months. One patient had a marked improvement, being able to discontinue all the medications. A mean decrease in the BFM scores of 52,58 percent was noted. One patient had a trans-operative motor seizure followed by a transient hemiparesis secondary to rack hemorrhage; other was lethargic up to three days after the procedure.CONCLUSIONS:
Our results show that bilateral GPi pallidotomies may be a safe and effective approach to medically refractory generalized dystonias; it can also be speculated that the posttraumatic subgroup may not benefit with this procedure
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Técnicas Estereotáxicas
/
Distonia
/
Globo Pálido
Tipo de estudo:
Estudo prognóstico
Limite:
Adolescente
/
Adulto
/
Criança, pré-escolar
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Arq. neuropsiquiatr
Assunto da revista:
Neurologia
/
Psiquiatria
Ano de publicação:
2001
Tipo de documento:
Artigo
País de afiliação:
Brasil
Instituição/País de afiliação:
Federal University of Paraná/BR
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