Department of Neurosurgery, University of Colorado School of Medicine, Aurora, CO, US.
Department of Neurology, University of Colorado School of Medicine, Aurora, CO, US.
Tremor Other Hyperkinet Mov (N Y). 2021 Nov 8;11:46. doi: 10.5334/tohm.645. eCollection 2021.
Globus pallidus internus (GPi) deep brain stimulation (DBS) and thalamotomy are interventions for writer's cramp (WC). Ventralis intermedius nucleus (VIM) DBS is targeted for tremor, however, many aspects of VIM DBS remained underexplored in WC.
A 62-year-old man with WC underwent DBS. Dystonic tremor improved intraoperatively with ventralis oralis anterior (VoA)/ventral oralis posterior (VoP) and with subthalamic nucleus stimulation; although greatest benefit was obtained with VIM stimulation. Sustained benefit with VIM DBS at ten months post-operative was obtained.
This case demonstrates an intraoperative approach in target selection and supports benefits of VIM DBS for WC.
This case highlights the intraoperative approach and clinical effects of VIM DBS in the treatment of medically refractory writer's cramp (WC). We contextualize our results from this case with previous reports of VoA/VoP stimulation for WC.
苍白球内侧（GPi）深部脑刺激（DBS）和丘脑切开术是治疗书写痉挛（WC）的干预措施。腹侧中间核（VIM）DBS 是针对震颤的，但 VIM DBS 在 WC 中的许多方面仍未得到充分探索。
一名 62 岁男性患有 WC，接受了 DBS 治疗。术中，腹侧前核（VoA）/腹侧后核（VoP）和丘脑底核刺激改善了肌张力障碍性震颤；尽管 VIM 刺激获得的益处最大。术后十个月，VIM DBS 持续获益。
本病例展示了一种术中目标选择方法，并支持 VIM DBS 治疗 WC 的益处。
本病例强调了 VIM DBS 治疗药物难治性书写痉挛（WC）的术中方法和临床效果。我们将从这个病例中得到的结果与 VoA/VoP 刺激治疗 WC 的先前报告联系起来。
