Article
The efficacy and long-term outcome of ventrooral-thalamotomy in the patients with task-specific focal hand dystonia
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Published: | June 4, 2012 |
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Objective: Task specific focal hand dystonia (TSFD) manifests only during specific activities. The patients with TSFD include many kinds of occupations, such as musician, typist, barber and others. We performed Ventrooral(Vo)-thalamotomy for the patients with occupational task specific focal hand dystonia and investigated their clinical outcomes.
Methods: 19 patients with medically intractable task-specific focal hand dystonia consisted of 15 musicians, 3 barbers and 1 cartoonist. The tentative target was determined at 2 mm posterior to the midpoint of the AC-PC line, 1mm dorsal to the AC-PC line and 15 mm lateral to the midline. This point corresponds to the junction between nuclei of anterior and posterior Vo of the thalamus. Thermocoagulation was performed for 30 seconds at 75°.
Results: The mean duration of symptoms were 8.3 years. The mean age of onset were 33.9 years (male: 31.3, female: 38.3). Of 19, 17 patients remarkably demonstrated improved dystonic symptoms immediately after coagulation. In 2 patients, the symptoms did not change. Of 17 patients reacted to Vo-thalamotomy, 16 patients did not experience the recurrence or deterioration of symptoms during follow-up period. 1 patient experienced recurrence of dystonic symptoms 2 months after Vo-thalamotomy. 1 patient experienced weakness in the right leg after the left Vo-thalamotomy, which was considered to be a surgery-related complication.
Conclusions: Vo-thalamotomy is considered to be a rapid and long acting treatment for the patients with occupational task-specific focal hand dystonia.