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Dystonia as complication of thalamic neurosurgery.

Picillo, M; Paramanandam, V; Morgante, F; Algarni, M; Olszewska, DA; Munhoz, RP; Aziz, T; Pereira, E; Hodaie, M; Kalia, SK; et al. Picillo, M; Paramanandam, V; Morgante, F; Algarni, M; Olszewska, DA; Munhoz, RP; Aziz, T; Pereira, E; Hodaie, M; Kalia, SK; Lozano, AM; Lynch, T; Fasano, A (2019) Dystonia as complication of thalamic neurosurgery. Parkinsonism Relat Disord, 66. pp. 232-236. ISSN 1873-5126 https://doi.org/10.1016/j.parkreldis.2019.08.008
SGUL Authors: Pereira, Erlick Abilio Coelho Morgante, Francesca

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Abstract

BACKGROUND: Thalamotomy and deep brain stimulation of the ventralis intermedius nucleus are effective symptomatic treatments for tremor, irrespective of the underlying diagnosis. METHODS AND RESULTS: Herein we describe six tremor patients (2 Parkinson's disease, 1 dystonic tremor, 2 Essential tremor plus dystonia, 1 Essential tremor plus ataxia) who underwent thalamic neurosurgery and acutely or sub-acutely developed dystonia that was permanent in three cases and could not be managed with any adjustments in the stimulation settings. Tremor response was excellent. We argue that thalamic procedures disrupted either or both the cerebello-thalamic and the cortico-striato-pallido-thalamo-cortical loop resulting in an increase of the thalamo-cortical outflow and subsequent change in the clinical picture from tremor to dystonia. CONCLUSION: Thalamic neurosurgery might be rarely complicated by dystonia. Why some patients are more prone to develop this adverse event is still unknown and possibly related to intrinsic factors, which certainly need further studies.

Item Type: Article
Additional Information: © 2019. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
Keywords: DBS, Dystonia, Stimulation, Thalamus, Tremor, DBS, Dystonia, Stimulation, Thalamus, Tremor, 1103 Clinical Sciences, 1702 Cognitive Science, Neurology & Neurosurgery
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Parkinsonism Relat Disord
ISSN: 1873-5126
Language: eng
Dates:
DateEvent
September 2019Published
14 August 2019Published Online
11 August 2019Accepted
Publisher License: Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0
PubMed ID: 31434632
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/111244
Publisher's version: https://doi.org/10.1016/j.parkreldis.2019.08.008

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