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Rescue pallidotomy for dystonia through implanted deep brain stimulation electrode.
Patric Blomstedt1, Takaomi Taira2, Marwan Hariz3
1Department of Pharmacology and Clinical Neuroscience, Umeå University, Sweden.
Surgical Neurology International
|December 20, 2016
Summary
Deep brain stimulation (DBS) electrodes can be used for rescue lesions in patients with dystonia who cannot undergo re-implantation after infection. This approach provided a satisfactory outcome for dystonic symptoms in a case report.
Area of Science:
- Neurosurgery
- Neurology
- Movement Disorders
Background:
- Hardware-related infections necessitate implant removal in some deep brain stimulation (DBS) patients.
- Re-implantation is not always feasible for these patients.
- Rescue lesions using DBS electrodes are a potential alternative.
Observation:
- A case report details an elderly woman with bilateral Gpi DBS experiencing a hardware infection.
- A unilateral pallidotomy was performed using the existing DBS electrode before its removal.
- The patient experienced no adverse side effects.
Findings:
- The patient's Burke-Fahn-Marsden (BFM) dystonia movement scale score improved from 39 to 2.5 with DBS.
- Following the pallidotomy, the BFM score slightly increased to 5, indicating sustained efficacy.
- The procedure demonstrated a satisfactory effect on dystonic symptoms.
Implications:
- Rescue lesions via DBS electrodes, though off-label, may be a viable option for Gpi DBS patients with dystonia.
- This technique offers a potential solution for managing dystonia when re-implantation is contraindicated.
- Further consideration of this approach in select patient populations is warranted.
