Department of Neurosurgery, Paulo Niemeyer State Brain Institute, Rio de Janeiro, Brazil.
Neurosurg Focus. 2017 Jul;43(1):E2. doi: 10.3171/2017.4.FOCUS17134.
Pallidal stimulation has been the usual surgical treatment for dystonia in the last decades. The continuous investigation of the physiopathology and the motor pathways involved leads to the search for complementary targets to improve results. The authors present the case of a 37-year-old woman who had suffered from idiopathic hemidystonia with hyperkinetic and hypokinetic movements for 11 years, and who was treated with deep brain stimulation. A brief literature review is also provided. The globus pallidus internus and the ventral intermediate/ventral oral posterior complex of the thalamus were stimulated separately and simultaneously for 3 months and compared using the Burke-Fahn-Marsden Dystonia Rating Scale and the Global Dystonia Severity Rating Scale, with a 3.5-year follow-up. The synergism of multiple-target stimulation resulted in a complete improvement of the mixed dystonic symptoms.
在过去的几十年中，苍白球刺激一直是治疗肌张力障碍的常用手术方法。对病理生理学和涉及的运动通路的持续研究导致人们寻找补充靶点以提高治疗效果。作者报告了一位 37 岁女性的病例，她患有特发性半侧肌张力障碍，有 11 年的多动和少动运动病史，接受了深部脑刺激治疗。还提供了简短的文献回顾。分别和同时刺激苍白球 internus 和丘脑腹侧中间/腹侧口后复合体 3 个月，并使用 Burke-Fahn-Marsden 肌张力障碍评定量表和全球肌张力障碍严重程度评定量表进行比较，随访 3.5 年。多靶点刺激的协同作用使混合性肌张力障碍症状完全改善。
