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Globus pallidus internus pallidotomy for generalized dystonia

✍ Scribed by Dr. Andres M. Lozano; R. Kumar; R. E. Gross; N. Giladi; W. D. Hutchison; J. O. Dostrovsky; Anthony E. Lang

Book ID
102948671
Publisher
John Wiley and Sons
Year
1997
Tongue
English
Weight
769 KB
Volume
12
Category
Article
ISSN
0885-3185

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✦ Synopsis

The authors present a young boy with severe generalized dystonia treated with bilateral simultaneous pallidotomy. Microelectrode recordings with the patient under propofol anesthesia showed that the mean discharge rate of globus pallidus internus (GPi) neurons was between 21 and 31 Hz. This contrasts sharply with the mean GPi neuronal firing rates of approximately 80 Hz that are characteristic of Parkinson's disease. The patient had no immediate benefit from surgery, but a progressive improvement in both axial and limb dystonia began within 3 days. The Burke-Fahn-Marsden scores were 75 (maximum possible = 120) at baseline, 52 at 5 days, and 16 at 3 months after surgery. The mechanism of action of pallidotomy for dystonia and the reasons for the delayed and progressive improvement are unknown. Nevertheless, the magnitude of the improvement and the safety of the procedure in this one patient warrant a careful evaluation of pallidotomy for dystonia.

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