Stereotactic and functional neurosurgery
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Stereotact Funct Neurosurg · Jan 2012
Rechargeable deep brain stimulators in the management of paediatric dystonia: well tolerated with a low complication rate.
Deep brain stimulation (DBS) is a recognised method of treatment for primary and secondary dystonia. The size of non-rechargeable batteries has limited their use in small children. Our severe dystonia patients have required battery replacement every 20-24 months. ⋯ Activa was found to offer reliable stimulation with a low rate of significant complications and a suitable treatment option for children with dystonia.
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Stereotact Funct Neurosurg · Jan 2012
Vagoglossopharyngeal neuralgia treated by microvascular decompression and glossopharyngeal rhizotomy: clinical results of 21 cases.
Microvascular decompression (MVD) and rhizotomy are all selected for treating vagoglossopharyngeal neuralgia (VGPN). Nonetheless, controversies still exist about their curative effect on VGPN. Here we evaluate the effectiveness of MVD together with rhizotomy of the glossopharyngeal nerve for the treatment of VGPN. ⋯ Intracranial vagoglossopharyngeal nerve MVD with glossopharyngeal rhizotomy is an effective and safe procedure to treat VGPN.
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Stereotact Funct Neurosurg · Jan 2012
Deep brain stimulation hardware complications in patients with movement disorders: risk factors and clinical correlations.
Deep brain stimulation (DBS) has proven to be an effective treatment for Parkinson's disease (PD) and other movement disorders, but its usefulness is limited by complications related to the hardware. ⋯ DBS is a safe intervention with a relatively low rate of hardware complications.
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Stereotact Funct Neurosurg · Jan 2012
Case ReportsGlobus pallidus interna deep brain stimulation improves chorea and functional status in a patient with chorea-acanthocytosis.
We report a 39-year-old woman with chorea-acanthocytosis (ChAc) who was referred with refractory hyperkinetic movement and truncal bending spasm. She was diagnosed with ChAc with clinical features and laboratory findings of acanthocytosis in peripheral blood smear, and genetic studies revealed novel mutations in the VPS13 gene. Because her symptoms did not respond well to medical treatment, she was in a totally dependent state. ⋯ After the operation her hyperkinetic movement, bradykinesia, and truncal bending motion were improved, the preoperative total score of the motor section on the Unified Huntington's Disease Rating Scale (UHDRS) was 44, the independence scale was 50, and functional capacity was 1. However, a year after GPi-DBS, the postoperative score on the motor section was 12, the independence scale was 80, functional capacity was 9, and she had become capable of independent daily life. Although there is currently no curative treatment for ChAc, GPi-DBS represents a promising option for symptomatic control.
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Stereotact Funct Neurosurg · Jan 2012
Case ReportsGamma knife radiosurgery for recurrent glossopharyngeal neuralgia after microvascular decompression.
We report the first application of Gamma Knife radiosurgery (GKR) for recurrent glossopharyngeal neuralgia (GN) after microvascular decompression (MVD). The patient is a 51-year-old male with left-sided GN. He underwent MVD and did well for almost 4 years. Later on, the patient started to experience recurrent intolerable throat pain, frequently 10/10 in intensity. Based on the application of radiosurgery for trigeminal neuralgia, GKR was offered to the patient. ⋯ GKR, which is now widely used for refractory trigeminal neuralgia, can be considered for refractory or recurrent GN. With a multidisciplinary approach and advanced neuroimaging, GKR is feasible for GN after MVD, despite the shortness of the intracranial cisternal nerve portion. Further studies are necessary to establish the role of GKR for refractory GN after MVD; however, given its rarity and the lack of experience with GKR for this condition, retrospective studies with dozens of patients are almost impossible at this time.