• Takashi Asahi, Takaomi Taira, Kiyonobu Ikeda, Shiro Horisawa, Jiro Yamamoto, Hiroyuki Tsubono, and Shuji Sato.
• Department of Neurosurgery, Kanazawa Neurosurgical Hospital, Kanazawa, Ishikawa, Japan. Electronic address: takashi-tym@umin.ac.jp.
• World Neurosurg. 2019 Jul 1; 127: 8-10.

BackgroundStereotactic ventro-oral thalamotomy has been performed in cases of focal task-specific dystonia, including writer's cramp, with excellent outcomes. However, no reports have revealed the outcome of ventro-oral thalamotomy in a patient with a contralateral cerebral lesion. We describe a patient with left-hand writer's cramp with an old lesion in the left hemisphere and transient gait disturbance after right ventro-oral thalamotomy.Case DescriptionA 43-year-old man had a hemorrhage in the left basal ganglia due to cerebral arteriovenous malformation at 22 years of age, and right hemiparesis remained as a sequela. He developed left-handed writing ability; however, he became aware of the stiffness of his left hand and difficulty in writing. Writer's cramp was diagnosed. Medical treatments were not effective, and right ventro-oral thalamotomy was performed. Although his writing ability improved, he could not walk. After performing rehabilitation, his walking completely improved, reaching the level before surgery, after 3 months, and his writer's cramp was completely cured.ConclusionsIn patients with basal nucleus lesions, gait disturbance may appear transiently after contralateral thalamotomy. It is crucial to fully explain the potential complications, particularly in relation to temporal gait disturbances, and obtain informed consent.Copyright © 2019 Elsevier Inc. All rights reserved.

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