Subthalamotomy in Cervical Dystonia : A Case Study of Lesion Location and Clinical Outcome
Identifieur interne : 001083 ( PascalFrancis/Checkpoint ); précédent : 001082; suivant : 001084Subthalamotomy in Cervical Dystonia : A Case Study of Lesion Location and Clinical Outcome
Auteurs : Christian K. E. Moll [Allemagne] ; Wolfgang Hamel [Allemagne] ; Christoph B. Ostertag [Allemagne] ; Dieter Müller [Allemagne] ; Jiirgen Finsterbusch [Allemagne] ; Andreas K. Engel [Allemagne] ; Alexander Münchau [Allemagne]Source :
- Movement disorders [ 0885-3185 ] ; 2008.
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Abstract
Here we report a 63-year-old woman with primary cervical dystonia (CD) whose symptoms subsided for more than 30 years following a unilateral stereotactic subthalamotomy contralateral to the overactive left sternocleidomastoid muscle but then gradually recurred over a period of several months. The aim of the present study was to correlate the topography of the stereotactic lesion with the long lasting therapeutic effect. High-resolution magnetic resonance imaging and subsequent stereotactic analysis were performed to determine the anatomical localization of the lesion. The primary coagulation focus comprised the posterior subthalamic white matter in the prelemniscal radiation and field H of Forel. Neighboring structures were implicated to various extents. It is suggested that the posterior subthalamic area, with its abundance of interconnecting fibers and related nuclei, represents an effective target for the neurosurgical treatment of CD that may be explored further with deep brain stimulation.
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E." last="Moll">Christian K. E. Moll</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Neurophysiology and Pathophysiology, Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf</s1><s2>Hamburg</s2><s3>DEU</s3><sZ>1 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><settlement type="city">Hambourg</settlement><region type="land" nuts="2">Hambourg</region></placeName></affiliation></author><author><name sortKey="Hamel, Wolfgang" sort="Hamel, Wolfgang" uniqKey="Hamel W" first="Wolfgang" last="Hamel">Wolfgang Hamel</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Department of Neurosurgery, University Medical Center Hamburg-Eppendorf</s1><s2>Hamburg</s2><s3>DEU</s3><sZ>2 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><settlement type="city">Hambourg</settlement><region type="land" nuts="2">Hambourg</region></placeName></affiliation></author><author><name sortKey="Ostertag, Christoph B" sort="Ostertag, Christoph B" uniqKey="Ostertag C" first="Christoph B." last="Ostertag">Christoph B. Ostertag</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Department of Stereotactic and Functional Neurosurgery, University-Hospital Freiburg</s1><s2>Freiburg</s2><s3>DEU</s3><sZ>3 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Fribourg-en-Brisgau</region><settlement type="city">Fribourg-en-Brisgau</settlement></placeName></affiliation></author><author><name sortKey="Muller, Dieter" sort="Muller, Dieter" uniqKey="Muller D" first="Dieter" last="Müller">Dieter Müller</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Department of Neurosurgery, University Medical Center Hamburg-Eppendorf</s1><s2>Hamburg</s2><s3>DEU</s3><sZ>2 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><settlement type="city">Hambourg</settlement><region type="land" nuts="2">Hambourg</region></placeName></affiliation></author><author><name sortKey="Finsterbusch, Jiirgen" sort="Finsterbusch, Jiirgen" uniqKey="Finsterbusch J" first="Jiirgen" last="Finsterbusch">Jiirgen Finsterbusch</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf</s1><s2>Hamburg</s2><s3>DEU</s3><sZ>5 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><settlement type="city">Hambourg</settlement><region type="land" nuts="2">Hambourg</region></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Neuroimage Nord, University Medical Centers Hamburg-Kiel-Lubeck</s1><s3>DEU</s3><sZ>5 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>University Medical Centers Hamburg-Kiel-Lubeck</wicri:noRegion><wicri:noRegion>Neuroimage Nord, University Medical Centers Hamburg-Kiel-Lubeck</wicri:noRegion></affiliation></author><author><name sortKey="Engel, Andreas K" sort="Engel, Andreas K" uniqKey="Engel A" first="Andreas K." last="Engel">Andreas K. Engel</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Neurophysiology and Pathophysiology, Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf</s1><s2>Hamburg</s2><s3>DEU</s3><sZ>1 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><settlement type="city">Hambourg</settlement><region type="land" nuts="2">Hambourg</region></placeName></affiliation></author><author><name sortKey="Munchau, Alexander" sort="Munchau, Alexander" uniqKey="Munchau A" first="Alexander" last="Münchau">Alexander Münchau</name><affiliation wicri:level="3"><inist:fA14 i1="06"><s1>Department of Neurology, University Medical Center Hamburg-Eppendorf</s1><s2>Hamburg</s2><s3>DEU</s3><sZ>7 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><settlement type="city">Hambourg</settlement><region type="land" nuts="2">Hambourg</region></placeName></affiliation></author></analytic><series><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno><imprint><date when="2008">2008</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Case study</term><term>Dystonia</term><term>Nervous system diseases</term><term>Nuclear magnetic resonance imaging</term><term>Prognosis</term><term>Subthalamic nucleus</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Dystonie</term><term>Pathologie du système nerveux</term><term>Etude cas</term><term>Pronostic</term><term>Noyau sousthalamique</term><term>Imagerie RMN</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Here we report a 63-year-old woman with primary cervical dystonia (CD) whose symptoms subsided for more than 30 years following a unilateral stereotactic subthalamotomy contralateral to the overactive left sternocleidomastoid muscle but then gradually recurred over a period of several months. The aim of the present study was to correlate the topography of the stereotactic lesion with the long lasting therapeutic effect. High-resolution magnetic resonance imaging and subsequent stereotactic analysis were performed to determine the anatomical localization of the lesion. The primary coagulation focus comprised the posterior subthalamic white matter in the prelemniscal radiation and field H of Forel. Neighboring structures were implicated to various extents. It is suggested that the posterior subthalamic area, with its abundance of interconnecting fibers and related nuclei, represents an effective target for the neurosurgical treatment of CD that may be explored further with deep brain stimulation.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0885-3185</s0></fA01><fA03 i2="1"><s0>Mov. disord.</s0></fA03><fA05><s2>23</s2></fA05><fA06><s2>12</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Subthalamotomy in Cervical Dystonia : A Case Study of Lesion Location and Clinical Outcome</s1></fA08><fA11 i1="01" i2="1"><s1>MOLL (Christian K. E.)</s1></fA11><fA11 i1="02" i2="1"><s1>HAMEL (Wolfgang)</s1></fA11><fA11 i1="03" i2="1"><s1>OSTERTAG (Christoph B.)</s1></fA11><fA11 i1="04" i2="1"><s1>MÜLLER (Dieter)</s1></fA11><fA11 i1="05" i2="1"><s1>FINSTERBUSCH (Jiirgen)</s1></fA11><fA11 i1="06" i2="1"><s1>ENGEL (Andreas K.)</s1></fA11><fA11 i1="07" i2="1"><s1>MÜNCHAU (Alexander)</s1></fA11><fA14 i1="01"><s1>Department of Neurophysiology and Pathophysiology, Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf</s1><s2>Hamburg</s2><s3>DEU</s3><sZ>1 aut.</sZ><sZ>6 aut.</sZ></fA14><fA14 i1="02"><s1>Department of Neurosurgery, University Medical Center Hamburg-Eppendorf</s1><s2>Hamburg</s2><s3>DEU</s3><sZ>2 aut.</sZ><sZ>4 aut.</sZ></fA14><fA14 i1="03"><s1>Department of Stereotactic and Functional Neurosurgery, University-Hospital Freiburg</s1><s2>Freiburg</s2><s3>DEU</s3><sZ>3 aut.</sZ></fA14><fA14 i1="04"><s1>Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf</s1><s2>Hamburg</s2><s3>DEU</s3><sZ>5 aut.</sZ></fA14><fA14 i1="05"><s1>Neuroimage Nord, University Medical Centers Hamburg-Kiel-Lubeck</s1><s3>DEU</s3><sZ>5 aut.</sZ></fA14><fA14 i1="06"><s1>Department of Neurology, University Medical Center Hamburg-Eppendorf</s1><s2>Hamburg</s2><s3>DEU</s3><sZ>7 aut.</sZ></fA14><fA20><s1>1751-1756</s1></fA20><fA21><s1>2008</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>20953</s2><s5>354000196067980170</s5></fA43><fA44><s0>0000</s0><s1>© 2008 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>27 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>08-0487390</s0></fA47><fA60><s1>P</s1><s3>CC</s3></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Movement disorders</s0></fA64><fA66 i1="01"><s0>USA</s0></fA66><fC01 i1="01" l="ENG"><s0>Here we report a 63-year-old woman with primary cervical dystonia (CD) whose symptoms subsided for more than 30 years following a unilateral stereotactic subthalamotomy contralateral to the overactive left sternocleidomastoid muscle but then gradually recurred over a period of several months. The aim of the present study was to correlate the topography of the stereotactic lesion with the long lasting therapeutic effect. High-resolution magnetic resonance imaging and subsequent stereotactic analysis were performed to determine the anatomical localization of the lesion. The primary coagulation focus comprised the posterior subthalamic white matter in the prelemniscal radiation and field H of Forel. Neighboring structures were implicated to various extents. It is suggested that the posterior subthalamic area, with its abundance of interconnecting fibers and related nuclei, represents an effective target for the neurosurgical treatment of CD that may be explored further with deep brain stimulation.</s0></fC01><fC02 i1="01" i2="X"><s0>002B17</s0></fC02><fC02 i1="02" i2="X"><s0>002B17H</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Dystonie</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Dystonia</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Distonía</s0><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Pathologie du système nerveux</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Nervous system diseases</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Sistema nervioso patología</s0><s5>02</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Etude cas</s0><s5>09</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Case study</s0><s5>09</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Estudio caso</s0><s5>09</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Pronostic</s0><s5>10</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Prognosis</s0><s5>10</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Pronóstico</s0><s5>10</s5></fC03><fC03 i1="05" i2="X" l="FRE"><s0>Noyau sousthalamique</s0><s5>11</s5></fC03><fC03 i1="05" i2="X" l="ENG"><s0>Subthalamic nucleus</s0><s5>11</s5></fC03><fC03 i1="05" i2="X" l="SPA"><s0>Núcleo subtalámico</s0><s5>11</s5></fC03><fC03 i1="06" i2="X" l="FRE"><s0>Imagerie RMN</s0><s5>12</s5></fC03><fC03 i1="06" i2="X" l="ENG"><s0>Nuclear magnetic resonance imaging</s0><s5>12</s5></fC03><fC03 i1="06" i2="X" l="SPA"><s0>Imaginería RMN</s0><s5>12</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Syndrome extrapyramidal</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Extrapyramidal syndrome</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Extrapiramidal síndrome</s0><s5>37</s5></fC07><fC07 i1="02" i2="X" l="FRE"><s0>Mouvement involontaire</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="ENG"><s0>Involuntary movement</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="SPA"><s0>Movimiento involuntario</s0><s5>38</s5></fC07><fC07 i1="03" i2="X" l="FRE"><s0>Pathologie du muscle strié</s0><s5>39</s5></fC07><fC07 i1="03" i2="X" l="ENG"><s0>Striated muscle disease</s0><s5>39</s5></fC07><fC07 i1="03" i2="X" l="SPA"><s0>Músculo estriado patología</s0><s5>39</s5></fC07><fC07 i1="04" i2="X" l="FRE"><s0>Trouble neurologique</s0><s5>41</s5></fC07><fC07 i1="04" i2="X" l="ENG"><s0>Neurological disorder</s0><s5>41</s5></fC07><fC07 i1="04" i2="X" l="SPA"><s0>Trastorno neurológico</s0><s5>41</s5></fC07><fC07 i1="05" i2="X" l="FRE"><s0>Encéphale</s0><s5>42</s5></fC07><fC07 i1="05" i2="X" l="ENG"><s0>Encephalon</s0><s5>42</s5></fC07><fC07 i1="05" i2="X" l="SPA"><s0>Encéfalo</s0><s5>42</s5></fC07><fC07 i1="06" i2="X" l="FRE"><s0>Système nerveux central</s0><s5>43</s5></fC07><fC07 i1="06" i2="X" l="ENG"><s0>Central nervous system</s0><s5>43</s5></fC07><fC07 i1="06" i2="X" l="SPA"><s0>Sistema nervioso central</s0><s5>43</s5></fC07><fC07 i1="07" i2="X" l="FRE"><s0>Pathologie de l'encéphale</s0><s5>44</s5></fC07><fC07 i1="07" i2="X" l="ENG"><s0>Cerebral disorder</s0><s5>44</s5></fC07><fC07 i1="07" i2="X" l="SPA"><s0>Encéfalo patología</s0><s5>44</s5></fC07><fC07 i1="08" i2="X" l="FRE"><s0>Pathologie du système nerveux central</s0><s5>45</s5></fC07><fC07 i1="08" i2="X" l="ENG"><s0>Central nervous system disease</s0><s5>45</s5></fC07><fC07 i1="08" i2="X" l="SPA"><s0>Sistema nervosio central patología</s0><s5>45</s5></fC07><fN21><s1>316</s1></fN21><fN44 i1="01"><s1>OTO</s1></fN44><fN82><s1>OTO</s1></fN82></pA></standard></inist><affiliations><list><country><li>Allemagne</li></country><region><li>Bade-Wurtemberg</li><li>District de Fribourg-en-Brisgau</li><li>Hambourg</li></region><settlement><li>Fribourg-en-Brisgau</li><li>Hambourg</li></settlement></list><tree><country name="Allemagne"><region name="Hambourg"><name sortKey="Moll, Christian K E" sort="Moll, Christian K E" uniqKey="Moll C" first="Christian K. E." last="Moll">Christian K. E. Moll</name></region><name sortKey="Engel, Andreas K" sort="Engel, Andreas K" uniqKey="Engel A" first="Andreas K." last="Engel">Andreas K. Engel</name><name sortKey="Finsterbusch, Jiirgen" sort="Finsterbusch, Jiirgen" uniqKey="Finsterbusch J" first="Jiirgen" last="Finsterbusch">Jiirgen Finsterbusch</name><name sortKey="Finsterbusch, Jiirgen" sort="Finsterbusch, Jiirgen" uniqKey="Finsterbusch J" first="Jiirgen" last="Finsterbusch">Jiirgen Finsterbusch</name><name sortKey="Hamel, Wolfgang" sort="Hamel, Wolfgang" uniqKey="Hamel W" first="Wolfgang" last="Hamel">Wolfgang Hamel</name><name sortKey="Muller, Dieter" sort="Muller, Dieter" uniqKey="Muller D" first="Dieter" last="Müller">Dieter Müller</name><name sortKey="Munchau, Alexander" sort="Munchau, Alexander" uniqKey="Munchau A" first="Alexander" last="Münchau">Alexander Münchau</name><name sortKey="Ostertag, Christoph B" sort="Ostertag, Christoph B" uniqKey="Ostertag C" first="Christoph B." last="Ostertag">Christoph B. Ostertag</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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