gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Long-term outcome of GPI stimulation in different types of dystonia

Langzeitverlauf der GPI Stimulation bei verschiedenen Formen der Dystonie

Meeting Abstract

Suche in Medline nach

  • corresponding author J. Mehrkens - Neurochirurgische Universitätsklinik, Klinikum Großhadern, Ludwig-Maximilians-Universität München
  • K. Bötzel - Neurologische Universitätsklinik, Klinikum Großhadern, Ludwig-Maximilians- Universität München
  • U. Steude - Neurochirurgische Universitätsklinik, Klinikum Großhadern, Ludwig-Maximilians-Universität München

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc11.05.-10.03

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2005/05dgnc0217.shtml

Veröffentlicht: 4. Mai 2005

© 2005 Mehrkens et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

GPI (globus pallidus internus) deep brain stimulation offers a very interesting stereotactic neurosurgical therapy for medically intractable dystonia (generalised, segmental, focal). Immediate post-operative results and clinical follow-up for 15 patients are reported.

Methods

GPI-deep brain stimulation was performed in 15 patients (age 12-78 years) suffering from primary generalised (3), segmental (10) or focal (2) dystonia. Electrode-implantation (DBS 3387, Medtronic) was performed under propofol anaesthesia with MRI-guided stereotaxy using a modified Leksel/Lerch system. The lowest possible electrode was chosen for stimulation and intensity was set relatively high from the beginning (mean 80µA). After one week of successful stimulation by an external test stimulation system, permanent implantation of the stimulation system (Soletra, Medtronic) was performed. Clinical outcome was assessed using the Burke-Fahn-Mardsen (BFM) motor and disability scores. Median follow-up was 36 months.

Results

All patients experienced a significant improvement of symptoms during the first week. After 3 months, symptom reduction was considered excellent in 6, fair in 5 and moderate in one patient. No improvement was observed in three patients. The BFM movement scores had improved in the range from 0 to 82% compared to preoperatively. After 30 months, relief of symptoms was unchanged compared to the 3-month status in 12, slightly reduced in two and severely reduced in one patient. Local infection occurred in one patient, making electrode-explantation necessary. Re-implantation was performed three months later without further complications. No other therapy-related morbidity was observed.

Conclusions

GPI deep brain stimulation offers a very effective and safe therapy for patients suffering from primary generalised, segmental or focal dystonia. Stable relief of symptoms can be achieved in the majority of patients.