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Camptocormia treated with bilateral pallidal stimulation: case report
Dipankar Nandi1, Simon Parkin, Richard Scott
1Laboratory of Physiology, University of Oxford, Oxford, United Kingdom.
Neurosurgical Focus
|October 11, 2005
Summary
Deep brain stimulation (DBS) of the globus pallidus internus (GPi) offers functional benefits for disabling camptocormia. This study found chronic pallidal stimulation safe and effective, improving patient function and providing insights into this rare condition.
Area of Science:
- Neurology
- Neurophysiology
- Neuropsychology
Background:
- Camptocormia is a disabling condition characterized by involuntary flexion of the trunk.
- Deep brain stimulation (DBS) is a potential therapeutic option for movement disorders.
- Targeting the globus pallidus internus (GPi) bilaterally is a novel approach for camptocormia.
Observation:
- High-frequency DBS electrodes were stereotactically implanted in the GPi bilaterally.
- Local field potentials (LFPs) and electromyography (EMG) were recorded during camptocormic episodes.
- Movement disorder assessments and neuropsychological evaluations were conducted pre- and post-stimulation.
Findings:
- Chronic bilateral pallidal stimulation led to significant functional improvement.
- Neuropsychological scores showed some improvement post-stimulation.
- GPi LFPs correlated temporally with rectus abdominis EMG activity, suggesting a physiological link.
Implications:
- Chronic pallidal stimulation is a safe and effective treatment for severe camptocormia.
- This study provides physiological insights into the pathophysiology of camptocormia.
- Pallidal DBS may offer a new therapeutic avenue for rare movement disorders.