gms | German Medical Science

62nd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Polish Society of Neurosurgeons (PNCH)

German Society of Neurosurgery (DGNC)

7 - 11 May 2011, Hamburg

Deep brain stimulation for idiopathic primary camptocormia

Meeting Abstract

  • D. Falk - Department of Neurosurgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel
  • R. Reese - Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel
  • M. Mahvash - Department of Neurosurgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel
  • J. Volkmann - Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel
  • H.M. Mehdorn - Department of Neurosurgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel

Deutsche Gesellschaft für Neurochirurgie. Polnische Gesellschaft für Neurochirurgen. 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH). Hamburg, 07.-11.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocP 017

doi: 10.3205/11dgnc238, urn:nbn:de:0183-11dgnc2389

Published: April 28, 2011

© 2011 Falk 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: Camptocormia is a rare syndrome, which is defined as an abnormal flexion of the thoracolumbal spine that appears in the upright position and increases during walking. It occurs in Parkinson's disease or Dystonia or it can appear as a primary idiopathic disease. In the literature, data on deep brain stimulation (DBS) for idiopathic primary camptocormia are extremely rare.

Methods: We report on two patients with primary idiopathic camptocormia. The first patient was a 54-year-old woman, who had suffered from camptocormia for 18 months prior to admission. The second patient was a 49-year-old man with a 1-year-history of the disease. Both reported on an acute beginning; no reason could be found and the symptoms were drug-resistant. As a therapeutic trial we performed a bilateral stimulation of the GPI using stereotactic MRI-planning, multiple trajectories for micro-recording and macro stimulation. Surgery was performed under general anesthesia.

Results: A typical GPI pattern was found along the trajectory analog to other dystonic patients. In addition, normal thresholds for motor side effects for an electrode position in the GPI could be detected. After starting permanent stimulation, improvement with up to a complete reduction of the dystonic movement could be achieved after 2 weeks for the first patient as well as 3 days for the second patient, which was sustained throughout the follow-up period of one year and 6 months, respectively.

Conclusions: Our two cases support that deep brain stimulation of the GPI could be an effective method in the treatment of primary camptocormia. More cases have to follow in order to support these findings.