Chronic stimulation of the globus pallidus internus for control of primary generalized dystonia.
Chronic stimulation of the globus pallidus internus for control of primary generalized dystonia.
复制标题
慢性刺激苍白球内部以控制原发性全身性肌张力障碍。
DOI：
10.1007/978-3-7091-6081-7_26
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发表时间：
2003
期刊：
影响因子：
--
通讯作者：
Takamitsu Yamamoto
中科院分区：
文献类型：
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作者：
Y. Katayama;C. Fukaya;Kazutaka Kobayashi;H. Oshima;Takamitsu Yamamoto
本文总结了苍白球脑深部电刺激治疗肌张力障碍的经验。共有5例原发性全身性肌张力障碍患者接受了GPi-DBS。3例男性，2例女性。肌张力障碍发作时的年龄范围为8至45岁，GPi-DBS手术时的年龄范围为17至59岁。其中两名患者曾在其他诊所接受双侧丘脑切开术或单侧苍白球切开术治疗，然后出现新的症状或复发。所有人都受到双侧刺激。未发生手术并发症。采用Burke-Fahn-Marsden肌张力障碍评定量表（BFMDRS）对肌张力障碍症状进行评分。术前评分18 ~ 62分。在开始GPi-DBS后不久观察到肌张力障碍症状的改善，并且在手术后数月甚至数年内观察到额外的进行性改善。术后6个月评分达到4 ~ 23分。评分改善范围为-51%至-92%。GPi-DBS产生了显着的效果，即使在患者谁曾接受丘脑或苍白球切开术。术后6个月时，所有患者均接受宽极距双极刺激，使用触点0或1作为阴极，触点2或3作为阳极。以约2.0 V的强度进行刺激，脉冲宽度为0.21 ms，高频范围为120至140 Hz。GPi-DBS是许多原发性全身性肌张力障碍患者的重要治疗选择。
Our experience of deep brain stimulation of the globus pallidus internus (GPi-DBS) for dystonia is summarized. A total of 5 patients with primary generalized dystonia underwent GPi-DBS. There were 3 males and 2 females. The age at onset of dystonia ranged from 8 to 45 years and the age at surgery for GPi-DBS ranged from 17 to 59 years. Two of the patients had been treated previously by bilateral thalamotomy or unilateral pallidotomy at other clinics and then developed new symptoms or recurrence. All were stimulated bilaterally. No surgical complications were encountered. The symptoms of dystonia were scored by the Burke-Fahn-Marsden dystonia rating scale (BFMDRS). The scores ranged from 18 to 62 before surgery. An improvement in the symptoms of dystonia was observed soon after the initiation of GPi-DBS, and additional progressive improvement was noted during a period of months or even years after surgery. The score at 6 months after surgery reached a level ranging from 4 to 23. The improvement in score ranged from -51% to -92%. GPi-DBS produced a marked effect even in patients who had previously undergone thalamotomy or pallidotomy. At 6 months after surgery, all patients were receiving bipolar stimulation with a wide interpolar distance, using contact 0 or 1 as the cathode and contact 2 or 3 as the anode. Stimulation was being performed at an intensity of around 2.0 V with a pulse width of 0.21 ms at a high frequency ranging from 120 to 140 Hz. GPi-DBS represents an important therapeutic option in many patients with primary generalized dystonia.