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立体定向口-前庭丘脑切开术治疗音乐家手口畸形的长期疗效。

Long-term improvement of musician's dystonia after stereotactic ventro-oral thalamotomy.

机构信息

Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan.

出版信息

Ann Neurol. 2013 Nov;74(5):648-54. doi: 10.1002/ana.23877. Epub 2013 Jun 17.

Abstract

OBJECTIVE

Musician's dystonia is a task-specific movement disorder that causes twisting or repetitive abnormal finger postures and movements, which tend to occur only while playing musical instruments. Such a movement disorder will probably lead to termination of the careers of affected professional musicians. Most of the currently available treatments have yet to provide consistent and satisfactory results. We present the long-term follow-up results of ventro-oral thalamotomy for 15 patients with musician's dystonia.

METHODS

Between October 2003 and September 2010, 15 patients with medically intractable task-specific focal hand dystonia that occurred only while playing musical instruments underwent ventro-oral thalamotomy. We used Tubiana's musician's dystonia scale to evaluate the patients' pre- and postoperative neurological conditions.

RESULTS

All patients except 1 (93%) experienced dramatic improvement of dystonic symptoms immediately after ventro-oral thalamotomy. The mean follow-up period was 30.8 months (range=4-108 months). None of the patients experienced recurrence or deterioration of symptoms during the follow-up periods.

INTERPRETATION

Ventro-oral thalamotomy remarkably improved musician's dystonia, and the effect persisted for a long duration.

摘要

目的

音乐家手痉挛是一种特定于任务的运动障碍,导致扭曲或重复的异常手指姿势和运动,这些姿势和运动往往只在演奏乐器时发生。这种运动障碍可能会导致受影响的职业音乐家的职业生涯结束。目前大多数可用的治疗方法尚未提供一致和令人满意的结果。我们报告了 15 例音乐家手痉挛患者接受腹侧口腔丘脑切开术的长期随访结果。

方法

2003 年 10 月至 2010 年 9 月期间,15 例经药物治疗无效的特定于任务的局灶性手部痉挛患者仅在演奏乐器时发生,接受了腹侧口腔丘脑切开术。我们使用 Tubiana 的音乐家手痉挛量表评估患者手术前后的神经状况。

结果

除 1 例(93%)外,所有患者在接受腹侧口腔丘脑切开术后立即出现明显的痉挛症状改善。平均随访时间为 30.8 个月(范围为 4-108 个月)。在随访期间,没有患者出现症状复发或恶化。

结论

腹侧口腔丘脑切开术显著改善了音乐家手痉挛,并且效果持续时间长。

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