对一名脑瘫患者进行小脑上脚高频深部脑刺激
High Frequency Deep Brain Stimulation of Superior Cerebellar Peduncles in a Patient with Cerebral Palsy.
作者信息
Lin Suzhen, Zhang Chencheng, Li Hongxia, Wang Yuhan, Wu Yunhao, Wang Tao, Pan Yixin, Sun Bomin, Wu Yiwen, Li Dianyou
机构信息
Department of Neurology and Institute of Neurology, Ruijin Hospital, affiliated with Shanghai Jiaotong University School of Medicine, Shanghai, CN.
Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, affiliated with Shanghai Jiaotong University School of Medicine, Shanghai, CN.
出版信息
Tremor Other Hyperkinet Mov (N Y). 2020 Oct 7;10:38. doi: 10.5334/tohm.551.
BACKGROUND
Globus pallidus internus (GPi) deep brain stimulation (DBS) is widely used in patients with isolated dystonia; however, its use remains controversial in patients with acquired dystonia and cerebral palsy.
CASE PRESENTATION
We report the first case of a cerebral palsy patient, who failed to recover 2 years after GPi DBS; DBS was administered on both superior cerebellar peduncles (SCPs) and dentate nuclei (DNs). The monopolar stimulation results suggested that DBS was better administered via the SCPs than via the DNs. At six months follow-up, the patient exhibited a significant improvement of dystonia and spasticity, as well as in her quality of life.
DISCUSSION
SCP DBS may be a potential treatment for cerebral palsy patients with dystonia and spasticity who do not respond well to GPi DBS.
背景
苍白球内侧部（GPi）深部脑刺激（DBS）广泛应用于孤立性肌张力障碍患者；然而，其在获得性肌张力障碍和脑瘫患者中的应用仍存在争议。
病例报告
我们报告了首例接受GPi DBS治疗2年后未恢复的脑瘫患者；双侧小脑上脚（SCPs）和齿状核（DNs）均进行了DBS治疗。单极刺激结果表明，经SCPs进行DBS治疗优于经DNs进行DBS治疗。随访6个月时，患者的肌张力障碍、痉挛以及生活质量均有显著改善。
讨论
SCP DBS可能是对GPi DBS反应不佳的伴有肌张力障碍和痉挛的脑瘫患者的一种潜在治疗方法。
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