Department of Clinical Neurosciences, University of Calgary, Alberta, Canada.
J Neurosurg. 2010 Jun;112(6):1267-70. doi: 10.3171/2009.10.JNS091062.
Myoclonic dystonia is poorly managed with medication and may be severe enough to warrant surgical intervention. Surgery has targeted either the globus pallidus pars interna (GPi) or the thalamus, but there is no accepted target for this condition. The authors present the case of a 23-year-old man treated with unilateral deep brain stimulation in both the thalamus and GPi. His movement disorder improved dramatically with stimulation. Two years postoperatively, the authors performed a double-blind assessment of the effects of each stimulator together, separately, and off stimulation. Videotape assessment, using tremor, dystonia, and myoclonus rating scales, showed that most of the benefit could be attributed to pallidal stimulation, although there was some advantage to stimulation at both sites. These results suggest that while GPi stimulation may be the better target for this condition, thalamic stimulation may be added in cases in which the benefit is insufficient.
肌阵挛性肌张力障碍药物治疗效果不佳，可能严重到需要手术干预。手术的目标是苍白球内侧部（GPi）或丘脑，但对于这种情况，没有公认的靶点。作者介绍了一名 23 岁的男性患者，他接受了丘脑和 GPi 双侧深部脑刺激治疗。他的运动障碍在刺激下明显改善。术后 2 年，作者对每个刺激器的联合、单独和关闭刺激的效果进行了双盲评估。使用震颤、肌张力障碍和肌阵挛评分的视频评估显示，大部分益处可归因于苍白球刺激，尽管两个部位的刺激都有一定的优势。这些结果表明，虽然 GPi 刺激可能是这种情况的更好靶点，但在获益不足的情况下，可以添加丘脑刺激。
