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59th Annual Meeting of the German Society of Neurosurgery (DGNC)
3rd Joint Meeting with the Italian Neurosurgical Society (SINch)

German Society of Neurosurgery (DGNC)

1 - 4 June 2008, Würzburg

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Deep brain stimulation for the treatment of movement disorders. Our experience on 28 cases in two years

Meeting Abstract

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  • corresponding author M. Pellizzari - Neurochirurgia, Dipartimento di Neuroscienze, Ospedale "Umberto I" Mestre, Venezia, Italy
  • C. Conti - Neurochirurgia, Dipartimento di Neuroscienze, Ospedale "Umberto I" Mestre, Venezia, Italy
  • G. Rizzo - Neurochirurgia, Dipartimento di Neuroscienze, Ospedale "Umberto I" Mestre, Venezia, Italy
  • M. Brollo - Neurochirurgia, Dipartimento di Neuroscienze, Ospedale "Umberto I" Mestre, Venezia, Italy
  • R. Eleopra - Neurologia, Dipartimento di Neuroscienze, Ospedale "Umberto I" Mestre, Venezia, Italy
  • G. Trincia - Neurochirurgia, Dipartimento di Neuroscienze, Ospedale "Umberto I" Mestre, Venezia, Italy

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocDI.07.05

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2008/08dgnc193.shtml

Published: May 30, 2008

© 2008 Pellizzari et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Demonstration of the safety and efficiency of DBS.

Methods: The choice of the patients was done using the following criteria: diagnosis of disease, duration of the disease, age, presence of side effect of medical therapy, absence of mental disease or structural brain lesions. The day before the operation the patient had a cerebral MRI, this exam is sent to a dedicated software. The targets are: GPi for dystonia, STN for Parkinson disease and nucleus Vim for essential tremor. The day of the operation the patient had a CT scan (with Leksell frame) and this exam is sent to the software. CT scan and MRI images are fused and we can calculate the stereotactic coordinates of the target. In operation room, to make the lead positioning more precise we register (microregistration) electrical activity from the entry point to the target; and after we begin the stimulation (macrostimulation) to rule out side effects. Five leads are used in dystonia and three in PD, we use multiple-simultaneous recording. The day after the operation the patients had a MRI control. After few days the patient has the second part of DBS operation; it consists in connecting the distal end of the stimulation electrode with a generator placed in a subclavicular subcutaneous pocket.

Results: In about two years (Oct. ’05 – Dec. ’07) we have performed 28 operations: 20 for Parkinson’s disease, 6 for dystonia, 2 for essential tremor. We had only one surgical complication: a small SAH. We submit our patients to regular follow-up after one year. Currently we have the results of 11 patients treated for PD; we used UPDRS-III test. We found best performance in all the patients, range of improvement is 74% to 11% with average 52%. All the patients also use less drugs than before the operation (average 39%). Finally, we underline the importance of collaboration among different specialists for the success of this procedure.