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

The efficacy and long-term outcome of ventrooral-thalamotomy in the patients with task-specific focal hand dystonia

Meeting Abstract

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  • S. Horisawa - Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo, Japan
  • T. Taira - Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo, Japan
  • S. Goto - Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo, Japan
  • Y. Okada - Department of Neurosurgery, Neurological Institute, Tokyo Women's 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. DocP 040

DOI: 10.3205/12dgnc427, URN: urn:nbn:de:0183-12dgnc4276

Published: June 4, 2012

© 2012 Horisawa 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: 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.