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Subthalamotomy in cervical dystonia: A case study of lesion location and clinical outcome

✍ Scribed by Christian K.E. Moll; Wolfgang Hamel; Christoph B. Ostertag; Dieter Müller; Jürgen Finsterbusch; Andreas K. Engel; Alexander Münchau

Publisher
John Wiley and Sons
Year
2008
Tongue
English
Weight
641 KB
Volume
23
Category
Article
ISSN
0885-3185

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✦ Synopsis

Abstract

Here we report a 63‐year‐old woman with primary cervical dystonia (CD) whose symptoms subsided for more than 30 years following a unilateral stereotactic subthalamotomy contralateral to the overactive left sternocleidomastoid muscle but then gradually recurred over a period of several months. The aim of the present study was to correlate the topography of the stereotactic lesion with the long lasting therapeutic effect. High‐resolution magnetic resonance imaging and subsequent stereotactic analysis were performed to determine the anatomical localization of the lesion. The primary coagulation focus comprised the posterior subthalamic white matter in the prelemniscal radiation and field H of Forel. Neighboring structures were implicated to various extents. It is suggested that the posterior subthalamic area, with its abundance of interconnecting fibers and related nuclei, represents an effective target for the neurosurgical treatment of CD that may be explored further with deep brain stimulation. © 2008 Movement Disorder Society

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