Bilateral Focused Ultrasound Pallidotomy for Parkinson-Related Facial Dyskinesia-A Case Report.
Bilateral Focused Ultrasound Pallidotomy for Parkinson-Related Facial Dyskinesia-A Case Report.
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DOI：
10.1002/mdc3.13462
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发表时间：
2022-07
影响因子：
4
通讯作者：
Baumann, Christian R.
中科院分区：
文献类型：
--
作者：
Stieglitz, Lennart H.;Mahendran, Sujitha;Oertel, Markus F.;Baumann, Christian R.
出于安全原因，磁共振引导的高强度聚焦超声(MRgHiFUS)丘脑切开术和苍白球切开术目前仅被批准用于单侧治疗，但左旋多巴诱发的口面部运动障碍等轴性症状需要双侧治疗。我们报告了第一例成功的双侧MRgHiFUS苍白球切开术治疗帕金森氏病(PD)患者的峰值剂量运动障碍。这一治疗决定是基于患者不愿接受脑植入和泵治疗，以及他在祖国使用深度脑刺激中心的机会有限的事实。由于冠状病毒病(COVID)-19大流行的旅行限制，治疗计划为分阶段程序，间隔18个月。第二次治疗后，左旋多巴引起的口面部运动障碍缓解并改善了运动迟缓和僵硬，步态稳定，姿势反射良好。这一有希望的结果表明，在选定的伴有运动障碍的PD患者中，可以考虑分期双侧MRgHiFUS苍白球切开术。
For safety reasons, both magnetic resonance‐guided high‐intensity focused ultrasound (MRgHiFUS) thalamotomy and pallidotomy are currently approved exclusively for unilateral treatment, but axial symptoms like levodopa‐induced orofacial dyskinesia require a bilateral approach. We report the first case of successful bilateral MRgHiFUS pallidotomy for peak‐dose dyskinesia in a patient with Parkinson's disease (PD). The treatment decision was based on the patient's reluctance toward brain implants and pump therapies and the fact that he had limited access to a deep brain stimulation center in his home country. The treatment was planned as staged procedure with an interval of 18 months because of travel restrictions because of the coronavirus disease (COVID)‐19 pandemic. After the second treatment, levodopa‐induced orofacial dyskinesia remitted and improved bradykinesia and rigidity with stable gait and good postural reflexes. This promising result suggests that in selected PD patients with dyskinesia, staged bilateral MRgHiFUS pallidotomy might be considered.
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影响因子：
1.8
作者：
Gallay, Marc N.;Moser, David;Jeanmonod, Daniel
通讯作者：
Jeanmonod, Daniel
影响因子：
8.6
作者：
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通讯作者：
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影响因子：
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作者：
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影响因子：
3.4
作者：
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通讯作者：
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影响因子：
4.1
作者：
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通讯作者：
Fishman, Paul S.