Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
Neuromodulation. 2014 Dec;17(8):724-8. doi: 10.1111/ner.12162. Epub 2014 Feb 25.
Myoclonus-dystonia is a movement disorder characterized by childhood onset of myoclonus and dystonia. We report a case of the epsilon-sarcoglycan mutation-negative myoclonus-dystonia patient who underwent bilateral globus pallidus interna deep-brain stimulation with subsequent improvement of both myoclonus and dystonia.
A 37-year-old woman with myoclonic jerks and dystonia affecting predominantly the lower limbs was treated with chronic bilateral globus pallidus interna deep-brain stimulation.
The movement subscore of the Burke-Fahns-Marsden Dystonia Rating Scale was 38 before surgery and improved to 7 after 3 years. The disability subscore of the Burke-Fahns-Marsden Dystonia Rating Scale improved from 7 to 2. The Unified Myoclonus Rating Scale also decreased significantly from 93 to 39. No hardware- or stimulation-related complications occurred during follow-up.
This report suggests that patients with myoclonus-dystonia may significantly benefit from bilateral globus pallidus interna deep-brain stimulation. Larger studies of this patient population are needed to confirm the optimal target.
肌阵挛-肌张力障碍是一种以儿童期起病的肌阵挛和肌张力障碍为特征的运动障碍。我们报告了一例epsilon- 横纹肌聚糖突变阴性的肌阵挛-肌张力障碍患者,该患者接受了双侧苍白球内侧深部脑刺激治疗,随后肌阵挛和肌张力障碍均得到改善。
一名 37 岁女性,以肌阵挛性抽搐和主要影响下肢的肌张力障碍为特征,接受了慢性双侧苍白球内侧深部脑刺激治疗。
手术前 Burke-Fahns-Marsden 肌张力障碍评定量表的运动评分子项为 38,3 年后改善至 7。Burke-Fahns-Marsden 肌张力障碍评定量表的残疾评分子项从 7 改善至 2。统一肌阵挛评定量表也从 93 显著下降至 39。在随访过程中未发生与硬件或刺激相关的并发症。
本报告提示肌阵挛-肌张力障碍患者可能从双侧苍白球内侧深部脑刺激中显著获益。需要对该患者人群进行更大规模的研究以确定最佳靶点。