Horisawa Shiro, Kawamata Takakazu, Taira Takaomi
Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan.
Surg Neurol Int. 2022 Dec 23;13:586. doi: 10.25259/SNI_840_2022. eCollection 2022.
Reports on the long-term effects of pallidotomy for cervical dystonia remain scarce.
We report a case of cervical dystonia successfully treated by unilateral pallidotomy. The patient was a 29-year-old man without past medical and family history of cervical dystonia. At the age of 28 years, neck rotation to the right with right shoulder elevation developed and gradually became worse. After symptoms failed to respond to repetitive botulinum toxin injections and oral medications, he underwent left pallidotomy, which resulted in significant improvement of cervical dystonia and shoulder elevation without surgical complications. At the 3-month evaluation, the symptoms completely improved. The Toronto Western Spasmodic Torticollis Rating Scale score dramatically improved from 39 points before surgery to 0 points at 7-year postoperative evaluation.
This case suggests that unilateral pallidotomy can be an alternative treatment option for cervical dystonia.
关于苍白球切开术治疗颈部肌张力障碍的长期效果的报道仍然很少。
我们报告一例通过单侧苍白球切开术成功治疗的颈部肌张力障碍病例。患者为一名29岁男性,既往无颈部肌张力障碍的病史及家族史。28岁时,出现颈部向右侧旋转并伴有右肩部抬高,且逐渐加重。在症状对重复肉毒杆菌毒素注射和口服药物均无反应后,他接受了左侧苍白球切开术,术后颈部肌张力障碍和肩部抬高明显改善,且无手术并发症。在3个月的评估中,症状完全改善。多伦多西部痉挛性斜颈评定量表评分从术前的39分大幅提高到术后7年评估时的0分。
该病例表明单侧苍白球切开术可作为颈部肌张力障碍的一种替代治疗选择。