Öz
Amaç: Hareket bozuklukları kas kasılmalarının hızı, niteliği ve fizibilitesini etkileyen nörolojik rahatsızlıklardır. Bu çalışmanın amacı, talamotomi ve kampotomi kombinasyonunun bir grup hasta üzerinde cerrahi sonuçlarının değerlendirilmesini ve daha önce bilinen uygulamalarla karşılaştırılmasıdır.
Gereç ve Yöntem: Bu çalışmaya 1997 ve 2003 yılları arasında talamotomi-kampotomi yapılan 25 distoni hastası dahil edilmiştir. Tüm hastalar aynı nörolog tarafından UPDRS ve Fahn-Burke-Marsden distoni skalalarına göre cerrahi öncesi ve sonrası dönemlerde değerlendirilmiştir.
Bulgular: Çalışmaya 18 erkek (%72) ve yedi kadın (%28) hasta (14-65 yaş, ortalama 26,6 yıl) dahil edilmiş olup genel distoni (n=11, %44), hemidistoni (n=8, %34) ve distonik tremor (n=6, %24) tanıları ile takip edilmişlerdir. Sekonder distoni tanısıyla izlenen 20 hastanın 18’i serebral palsi, bir multiple skleroz ve bir inme sonrası distoni olarak kabul edilmiştir.
Sonuç: Gpi DBS primer distoni hastalarında daha uygun bir uygulama olarak görülmektedir. Talamotomi-Kampotomi kombinasyonu sekonder distoni tanılı hastalarda başarılı bir metod olarak kabul edilebilir ve tedavi alternatifleri arasında değerlendirilmesi gereken bir seçenek olarak bulunmalıdır.
Anahtar Kelimeler
Distoni Talamotomi Kampotomi Hareket Bozuklukları Stereotaksi
Etik Beyan
-
Destekleyen Kurum
-
Proje Numarası
-
Teşekkür
-
Kaynakça
- 1. Oppenheim H. About a rare spasm disease of childhood and young age (Dysbasia lordotica progressiva, dystonia musculorum deformans). Neurologische Centralblatt. 1911;30:1090-1107.
- 2. Gowers WR. A manual of diseases of the nervous system. 2nd ed. London: Churchill; 1888.
- 3. Albanese A, Bhatia K, Bressman SB, et al. Phenomenology and classification of dystonia: A consensus update. Mov Disord. 2013;28:863-873.
- 4. Jinnah HA, Albanese A. The new classification for the dystonias: Why was it needed and how was it accomplished? Mov Disord Clin Pract. 2014;1:280- 284.
- 5. Lehéricy S, Tijssen MA, Vidailhet M, et al. The anatomical basis of dystonia: current view using neuroimaging. Mov Disord. 2013;28:944-957.
- 6. Ikoma K, Samii A, Mercuri B, et al. Abnormal cortical motor excitability in dystonia. Neurology. 1996;46:1371-1376.
- 7. Park J. Movement Disorders Following Cerebrovascular Lesion in the Basal Ganglia Circuit. J Mov Disord. 2016;9:71-79.
- 8. Cooper IS. Chemopallidectomy and chemothalamectomy for parkinsonism and dystonia. Proc R Soc Med. 1959;52:47-60.
- 9. Tasker RR, Doorly T, Yamashiro K. Thalamotomy in generalized dystonia. Adv Neurol. 1988;50:615-31.
- 10. Cardoso F, Jankovic J, Grossman RG, et al. Outcome after stereotactic thalamotomy for dystonia and hemiballismus. Neurosurgery. 1995;36:501- 507.
- 11. Iacono RP, Lonser RR, Yamada S. Contemporaneous bilateral postero-ventral pallidotomy for early onset “juvenile type” Parkinson’s disease. Case report. Acta Neurochir (Wien). 1994;131:247-252.
- 12. Lin JJ, Lin SZ, Lin GY, et al. Treatment of intractable generalized dystonia by bilateral posteroventral pallidotomy one-year results. Zhonghua Yi Xue Za Zhi (Taipei). 2001;64:231-238.
- 13. Vercueil L, Pollak P, Fraix V, et al. Deep brain stimulation in the treatment of severe dystonia. J Neurol. 2001;248:695-700.
- 14. Spiegel EA, Wycis HT, Szekely EG, et al. Campotomy in various extrapyramidal disorders. J Neurosurg. 1963;20:871-884.
- 15. Wycis HT, Spiegel EA. Campotomy in myoclonia. J Neurosurg. 1969;30:708- 713.
- 16. Imer M, Ozeren B, Karadereler S, et al. Destructive stereotactic surgery for treatment of dystonia. Surg Neurol. 2005;Suppl 2:89-94.
Öz
Objectives: Movement disorders are neurologic diseases that affect speed, quality and feasibility of muscle contractions. Aim of this study is, to assess the surgical outcomes of radiofrequency lesioning through deep brain stimulation (DBS) in a group of patients and comparing these results to the formerly known conventional procedures.
Materials and Methods: This study involved 25 dystonia patients in whom radiofrequency lesioning through DBS procedures were performed between 1997 and 2003. All of the patients were examined by the same neurologist and examined due to UPDRS, Fahn-Burke-Marsden dystonia rating scales pre and post operatively.
Results: Eighteen male (72%) and seven female (28%) patients (range=14-65 years, mean=26.6 years) with diagnosis of general dystonia (n=11,44%), hemidystonia (n=8, 34%) and dystonic tremor (n=6, 24%) enrolled in the study. Twenty patients with secondary dystonia involved 18 cerebral palsies, one multiple sclerosis and one poststroke dystonia cases.
Conclusion: Gpi DBS seems to be a more considerable approach for primary dystonia patients. Radiofrequency deep brain lesioning can be defined as a successful method for secondary dystonia treatment and must be implicated among treatment options.
Anahtar Kelimeler
Dystonia Thalamotomy Campotomy Movement Disorders Stereotaxic
Etik Beyan
Ethics Committee Approval: This is a retrospective archive study that does not need ethics approval. Informed Consent: Informed consent was taken from each patient preoperatively. Peer-review: Externally peer-reviewed. Authorship Contributions Surgical and Medical Practices: A.S., Concept: Ü.E., M.C.A., A.S., Design: Ü.E., A.S., Data Collection or Processing: Ü.E., M.C.A., A.S., Analysis or Interpretation: Ü.E., M.C.A., A.S., Literature Search: Ü.E., Writing: Ü.E., A.S. Conflict of Interest: No conflict of interest was declared by the authors. Financial Disclosure: The authors declared that this study received no financial support. Acknowledgments : This study was abstracted from data of a specialty thesis in neurosurgery at Ankara University School of Medicine, given by the first author (UE).
Destekleyen Kurum
-
Proje Numarası
-
Teşekkür
-
Kaynakça
- 1. Oppenheim H. About a rare spasm disease of childhood and young age (Dysbasia lordotica progressiva, dystonia musculorum deformans). Neurologische Centralblatt. 1911;30:1090-1107.
- 2. Gowers WR. A manual of diseases of the nervous system. 2nd ed. London: Churchill; 1888.
- 3. Albanese A, Bhatia K, Bressman SB, et al. Phenomenology and classification of dystonia: A consensus update. Mov Disord. 2013;28:863-873.
- 4. Jinnah HA, Albanese A. The new classification for the dystonias: Why was it needed and how was it accomplished? Mov Disord Clin Pract. 2014;1:280- 284.
- 5. Lehéricy S, Tijssen MA, Vidailhet M, et al. The anatomical basis of dystonia: current view using neuroimaging. Mov Disord. 2013;28:944-957.
- 6. Ikoma K, Samii A, Mercuri B, et al. Abnormal cortical motor excitability in dystonia. Neurology. 1996;46:1371-1376.
- 7. Park J. Movement Disorders Following Cerebrovascular Lesion in the Basal Ganglia Circuit. J Mov Disord. 2016;9:71-79.
- 8. Cooper IS. Chemopallidectomy and chemothalamectomy for parkinsonism and dystonia. Proc R Soc Med. 1959;52:47-60.
- 9. Tasker RR, Doorly T, Yamashiro K. Thalamotomy in generalized dystonia. Adv Neurol. 1988;50:615-31.
- 10. Cardoso F, Jankovic J, Grossman RG, et al. Outcome after stereotactic thalamotomy for dystonia and hemiballismus. Neurosurgery. 1995;36:501- 507.
- 11. Iacono RP, Lonser RR, Yamada S. Contemporaneous bilateral postero-ventral pallidotomy for early onset “juvenile type” Parkinson’s disease. Case report. Acta Neurochir (Wien). 1994;131:247-252.
- 12. Lin JJ, Lin SZ, Lin GY, et al. Treatment of intractable generalized dystonia by bilateral posteroventral pallidotomy one-year results. Zhonghua Yi Xue Za Zhi (Taipei). 2001;64:231-238.
- 13. Vercueil L, Pollak P, Fraix V, et al. Deep brain stimulation in the treatment of severe dystonia. J Neurol. 2001;248:695-700.
- 14. Spiegel EA, Wycis HT, Szekely EG, et al. Campotomy in various extrapyramidal disorders. J Neurosurg. 1963;20:871-884.
- 15. Wycis HT, Spiegel EA. Campotomy in myoclonia. J Neurosurg. 1969;30:708- 713.
- 16. Imer M, Ozeren B, Karadereler S, et al. Destructive stereotactic surgery for treatment of dystonia. Surg Neurol. 2005;Suppl 2:89-94.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Beyin ve Sinir Cerrahisi (Nöroşirurji) |
| Bölüm | Makaleler |
| Yazarlar | |
| Proje Numarası | - |
| Yayımlanma Tarihi | 2 Ekim 2019 |
| Yayımlandığı Sayı | Yıl 2019 Cilt: 72 Sayı: 2 |
