Surgical Interventions for Task-specific Dystonia (Writer's Dystonia)

Overview

Journal Ann Indian Acad Neurol

Specialty Neurology

Date 2017 Sep 15

PMID 28904473

Citations 13

Authors

Paresh K Doshi

Raghvendra Vijay Ramdasi

Bharati Karkera

Dilraj B Kadlas

Affiliations

Soon will be listed here.

Abstract

Objectives: Writer's cramp is a focal dystonia producing abnormal postures during selective motor activities. Thalamotomy or globus pallidus internus deep brain stimulation (GPi DBS) has been used as a surgical treatment in patients not responding to medical treatment.

Materials And Methods: Eight patients (all men, age 16-47 years) with refractory focal hand dystonia underwent either ventrooralis (Vo) thalamotomy (seven patients) or GPi DBS (one patient) using stereotactic techniques. Preoperative video recordings, Writing movment score for dystonic posture and latency of dystonia (WMS), and symptom severity scores (SSSs) were evaluated at baseline and latest follow-up ranging from 1 to 4 years.

Results: All patients had difficulty in performing their most common tasks. The duration of symptoms ranged from 6 months to 12 years. All patients obtained immediate postoperative relief from the dystonic symptoms, and the effect was sustained during the follow-up period. The WMS (range 0-28) improved from a mean of 14.5 before surgery to 2, whereas the SSS (maximum 43 and minimum 10) improved from a mean of 15.3 before surgery to 2 at the last follow-up. There were no surgical complications, morbidity, or mortality.

Conclusion: Vo thalamotomy or GPi DBS offers successful symptom relief in patients with task-specific dystonia.

Citing Articles

MRI-Guided Focused Ultrasound for the Treatment of Dystonia: A Narrative Review.

Momin S, Aquilina K, Bulstrode H, Taira T, Kalia S, Natalwala A Cureus. 2024; 16(2):e54284.

PMID: 38500932 PMC: 10945285. DOI: 10.7759/cureus.54284.

Outcomes of Unilateral Pallidotomy in Focal and Hemidystonia Cases: A Single-Blind Cohort Study.

Doshi P, Baldia M, Mulroy E, Krauss J, Bhatia K Mov Disord Clin Pract. 2024; 11(1):30-37.

PMID: 38291847 PMC: 10828613. DOI: 10.1002/mdc3.13912.

Evaluation of the efficacy and safety of MRI-guided focused ultrasound (MRgFUS) for focal hand dystonia: study protocol for an open-label non-randomised clinical trial.

Maamary J, Peters J, Kyle K, Ruge D, Jonker B, Barnett Y BMJ Neurol Open. 2023; 5(2):e000522.

PMID: 37900622 PMC: 10603452. DOI: 10.1136/bmjno-2023-000522.

Pistol Shooting Dystonia Treated with Thalamotomy.

Nishitani M, Horisawa S, Nonaka T, Kohara K, Mochizuki T, Kawamata T Tremor Other Hyperkinet Mov (N Y). 2023; 13:32.

PMID: 37692072 PMC: 10487115. DOI: 10.5334/tohm.779.

Case Report: Long-Term Suppression of Paroxysmal Kinesigenic Dyskinesia After Bilateral Thalamotomy.

Murakami M, Horisawa S, Azuma K, Akagawa H, Nonaka T, Kawamata T Front Neurol. 2021; 12:789468.

PMID: 34925221 PMC: 8678037. DOI: 10.3389/fneur.2021.789468.

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