Chae Minji, Hong Seungbeen, Jung Na Young, Chang Won Seok, Cho Sung-Rae
Department of Rehabilitation Medicine and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea.
Department of Neurosurgery and Brain Research Institute, Yonsei University College of Medicine, Seoul, Korea.
Ann Rehabil Med. 2019 Jun;43(3):335-340. doi: 10.5535/arm.2019.43.3.335. Epub 2019 Jun 28.
Deep brain stimulation (DBS) in internal globus pallidus is considered to be a good option for controlling generalized dystonia in patients with this condition. In this relation, it is known that DBS has already been shown to have significant effects on primary dystonia, but is seen as controversial in secondary dystonia including cerebral palsy (CP). On the other hand, intrathecal baclofen (ITB) has been known to reduce spasticity and dystonia in patients who did not respond to oral medications or botulinum toxin treatment. Here, we report a patient with dystonic CP, who received the ITB pump implantation long after the DBS and who noted remarkable improvement in the 36-Item Short Form Health Survey, Dystonia Rating Scale, Modified Barthel Index, and visual analog scale scores for pain after an ITB pump implantation was used as compared with DBS. To our knowledge, the present case report is the first to demonstrate the effects of an ITB pump on reducing pain and dystonia and improving quality of life and satisfaction, compared with DBS in a patient with CP.
内侧苍白球深部脑刺激（DBS）被认为是控制患有这种疾病的患者全身性肌张力障碍的一个好选择。在这方面，已知DBS已被证明对原发性肌张力障碍有显著效果，但在包括脑瘫（CP）在内的继发性肌张力障碍中存在争议。另一方面，鞘内注射巴氯芬（ITB）已被证实可减轻对口服药物或肉毒杆菌毒素治疗无反应患者的痉挛和肌张力障碍。在此，我们报告一名患有肌张力障碍性脑瘫的患者，该患者在DBS治疗很久之后接受了ITB泵植入，与DBS相比，使用ITB泵植入后，该患者在36项简短健康调查、肌张力障碍评定量表、改良巴氏指数以及疼痛视觉模拟量表评分方面均有显著改善。据我们所知，本病例报告首次证明了与DBS相比，ITB泵对减轻患有CP患者的疼痛和肌张力障碍以及改善生活质量和满意度的效果。
