Staged pallidotomy: MRI and clinical follow-up in status dystonicus

Angelo Franzini, Vincenzo Levi, Andrea Franzini, Ivano Dones, Giuseppe Messina

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: We report on a patient affected by Status Distonicus who was treated with Deep Brain Stimulation electrodes implanted in the Globus Pallidus internus (Gpi) and used for serial radiofrequency lesions. Materials and Methods: The evolution of radiofrequency lesions was monitored by post-operative and late Magnetic Resonance Imaging (MRI). After the first lesion the patient did improve, though not in a significant fashion. Therefore, three further radiofrequency lesions were delivered 2, 4 and 6 days respectively after surgery with subsequent improvement of dystonic movements. Results: MRI scans performed at 8 days, 3 months, and 6 months after surgery showed a diffuse T2-hyperintense and T1-hypointense GPi signal alteration which progressively decreased over time. Conclusion: We confirm that the possibility to stage pallidotomies over time using a couple of new contacts is a safe and efficacious procedure in treating SD patients where the lesions themselves are limited by the appearance of side effects, or in patients showing a poor response to a single lesion. As far as we know, this is the first description of MRI evolution and monitoring of a staged pallidotomy.

Original languageEnglish
Pages (from-to)1-4
Number of pages4
JournalBritish Journal of Neurosurgery
DOIs
Publication statusPublished - 2017

Keywords

  • generalized dystonia
  • globus pallidus internus
  • Staged pallidotomy
  • status dystonicus

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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