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Subthalamic deep brain stimulation in the treatment of secondary dystonia
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF NEUROSURGERY
- Issue:
- 12
- DOI:
- 10.3760/j.issn:1001-2346.2006.12.002
- Key Word:
- 丘脑底核;脑深部电刺激;继发性肌张力障碍
Abstract： 目的 探讨丘脑底核(STN)的脑深部电刺激(DBS)治疗继发性肌张力障碍的可行性、适应证和并发症.方法 5例行双侧STN-DBS,1例行单侧STN-DBS.结果 术中利用微电极记录的电信号获得STN的准确靶点定位,电刺激后患者肌张力有不同程度下降,但扭转改善不明显.随访半年至3年,6例患者中,药物引起的迟发性肌张力障碍及外伤性肌张力障碍的患者疗效理想,BFMDRS评分改善均在90%以上,且随着随访时间的延长,效果持续不断改善;其余4例患者疗效不佳,4例均肌张力略有改善,其中1例扭转略改善,1例语言及步态略有改善.手术后患者均无明显合并症,但1例术后16个月发现左侧电极折断,后取出.结论 DBS治疗迟发性和外伤性继发性肌张力障碍效果理想,而对于缺氧或脑基底节区弥漫性损害的继发性肌张力障碍效果不佳;STN可以成为治疗本病的理想靶点;术中应根据电生理记录结果和肌张力的轻度改善作为靶点定位的指标;手术无明显合并症.
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