gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

Pallidal stimulation for secondary dystonia due to anoxia. A case report

Meeting Abstract

  • M. Nakano - Department of Neurosurgery, Southern TOHOKU Fukushima Hospital, Fukushima, Japan
  • M. Oinuma - Department of Neurosurgery, Southern TOHOKU Fukushima Hospital, Fukushima, Japan
  • M. Sato - Department of Neurosurgery, Southern TOHOKU Fukushima Hospital, Fukushima, Japan
  • J. Asari - Department of Neurosurgery, Southern TOHOKU Fukushima Hospital, Fukushima, Japan
  • K. Watanabe - Department of Neurosurgery, Southern TOHOKU Fukushima Hospital, Fukushima, Japan
  • T. Taira - Department of Neurosurgery, Tokyo Womens’ Medical University, Tokyo, Japan

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocFR.10.10

DOI: 10.3205/12dgnc253, URN: urn:nbn:de:0183-12dgnc2532

Published: June 4, 2012

© 2012 Nakano 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

Text

Objective: Deep brain stimulation (DBS) for primary dystonia is already established, but the effect of DBS for secondary dystonia is controversial. We report on our experience of a successful case of pallidal stimulation for secondary dystonia after hypoxia.

Methods: A 47-year-old female suffered cardiopulmonary arrest because of her organic phosphorus drinking in suicidal intent. She woke up in the next day on the bed of intensive care unit. She was discharged after a few days without neurological deficit. Eight months after her discharge, she observed increasing involuntary movement, at first on her right leg, then torticollis movement of the neck to the right. She received some medication but the involuntary movement continued to get worse gradually. After 3 years after her hypoxic event, she had intractable dystonic movement on her neck and on the right-sided extremities, and her gait was ataxic, fluctuating up and down. We decided to target the left side of the brain because her symptoms were localized on the right side. We implanted two leads (Model 3387, Medtronic.co.) into the right internal globus pallidus, and the nucleus ventralis intermedius of the right thalamus. After a test stimulation for 2 weeks, pallidal stimulation was selected.

Results: On her discharge, the tortuous movement and the gait disturbance was improved. During 5 years of follow-up, the pallidal stimulation has been effective.

Conclusions: We think pallidal stimulation is worth trying for secondary dystonia with intractable movement.