Subthalamotomy in cervical dystonia: A case study of lesion location and clinical outcome

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 ai...

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Bibliographic Details
Published in:Movement disorders 2008-09, Vol.23 (12), p.1751-1756
Main Authors: Moll, Christian K.E., Hamel, Wolfgang, Ostertag, Christoph B., Müller, Dieter, Finsterbusch, Jürgen, Engel, Andreas K., Münchau, Alexander
Format: Article
Language:English
Subjects:
Biological and medical sciences
cervical dystonia
Diseases of striated muscles. Neuromuscular diseases
Female
Humans
Magnetic Resonance Imaging
Medical sciences
Middle Aged
Neurologic Examination
Neurology
Postoperative Period
stereotaxy
subthalamic nucleus
subthalamotomy
Subthalamus - surgery
Torticollis - pathology
Torticollis - surgery
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Summary: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. © 2008 Movement Disorder Society
ISSN:0885-3185
1531-8257
DOI:10.1002/mds.22088