Please use this identifier to cite or link to this item: https://observatorio.fm.usp.br/handle/OPI/8672
Title: Neurosurgical treatment for dystonia: Long-term outcome in a case series of 80 patients
Authors: MARTINEZ, Jairo Alberto EspinozaPINSKER, Marcus O.ARANGO, Gabriel J.GARCIA, XiomaraV, Oscar Andres EscobarFURLANETTI, LucianoREITHMEIER, ThomasARANDA, Inigo Alonso AguirreMARIN, Jorge HumbertoLOPEZ, William Omar Contreras
Citation: CLINICAL NEUROLOGY AND NEUROSURGERY, v.123, p.191-198, 2014
Abstract: Introduction: In this study, we assessed the outcomes of patients with dystonia who underwent surgery treatment following the same algorithm. Patients and methods: Eighty consecutive patients with dystonia were submitted to neurosurgical management by means of intrathecal pump implantation, pallidotomy or deep brain stimulation (GPi or VIM). These patients included 48 patients with primary dystonia and 32 patients with secondary dystonia. Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) was used to access pre- and postoperative outcomes. Patients were followed from 12 to 114 months. Results: Mean improvement in BFMDRS score among patients with PrD was 87.54% and 42.21% for SeD. Hemidystonic patients in both groups (PrD, SeD) showed a mean improvement in BFMDRS of 71.05% with GPiDBS. Patients with SeD due to previous perinatal insults showed a mean improvement in BFMDRS of 41.9%, with better results in purely dyskinetic patients (mean improvement of 61.2%). Conclusion: Use of the proposed algorithm facilitated surgical decision planning, which translated in improved diagnostic rates, earlier interventions, appropriate management plans, and outcomes for both groups (PrD, SeD). Therefore, neuroimaging findings had a positive prognostic significance in the response to treatment in patients with primary dystonia compared with patients with secondary dystonia or distortion of basal ganglia anatomy. However, further studies in this line are warranted.
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