Department of Neurology, Movement Disorders Center, School of Medicine, University of São Paulo, São Paulo, Brazil.
Neurosurgery Division, Department of Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil.
Stereotact Funct Neurosurg. 2021;99(5):451-453. doi: 10.1159/000515722. Epub 2021 Apr 23.
Meige syndrome is a segmental form of dystonia. It is a disabling disease, especially when refractory to treatment with botulinum toxin. A well-established therapeutic option is deep brain stimulation (DBS), and the target in bilateral globus pallidus internus (GPi DBS) demonstrated satisfactory short- and long-term efficacy. However, some patients present minor or suboptimal responses after GPi DBS, and in those cases, rescue DBS may be appropriate. The present case illustrates a good outcome after subthalamic nucleus (STN) and not after GPi DBS (considering that both were well positioned and had adequate programming). The larger dimension of the GPi and its somatotopic organization, with the stimulation outside the "face region," could explain our outcomes.
梅杰综合征是一种节段性的肌张力障碍。这是一种使人致残的疾病，特别是当对肉毒杆菌毒素的治疗产生抗药性时。一种成熟的治疗选择是脑深部电刺激（DBS），而双侧苍白球内（GPi DBS）的靶点显示出令人满意的短期和长期疗效。然而，一些患者在接受 GPi DBS 后表现出轻微或不理想的反应，在这种情况下，挽救性 DBS 可能是合适的。本病例说明了在丘脑底核（STN）刺激后的良好效果，而不是在 GPi DBS 刺激后（考虑到两者的位置都很好，且程控也很充分）。GPi 的更大尺寸及其躯体组织排列，刺激超出“面部区域”，可以解释我们的结果。
