[Value of bifocal stereotaxic destruction in case of dyskinesia in patients with a motor deficit of cerebral origin].
Authors report a study concerning 12 dyskinetic patients with cerebral palsy. The clinical pre-operative examination shows that many signs and symptoms are associated: volitional and postural dyskinesia, athetosis and dystonia, pyramidal deficit and spasticity. Talairach's stereotactic methodology has been used for bifocal (VPL thalamic nucleus and internal pallidum) Yttrium 90 implantation. After stereotactic bifocal lesions, involuntary movements have been reduced in 45.5% of cases and have disappeared in 27% of cases. Impairment of previous motor deficit has been observed in 3% of cases; volitional and postural dyskinesia seems to be the most curable symptomatology. Clinical results in athetoid involuntary movements and dystonia are less rewarding. Because of important anatomical modifications often observed cerebral palsy patients, the authors stress the interest of individual acute neurophysiological study and discuss about the stereotactic targets and the modalities of destruction. They insist upon the necessity of rigorous selection of indications based on acute clinical examination in the perspective of improvement of global functional capacities.
Blond
S
S
Service de Neurochirurgie, Centre Hospitalier Ste Anne, Paris.
Musolino
A
A
Munari
C
C
Gasnault
J
J
Chauvel
P
P
Chodkiewicz
J P
JP
Talairach
J
J
D000293:Adolescent; D002547:Cerebral Palsy / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005917:Globus Pallidus / Q000601:surgery*; D006801:Humans; D008297:Male; D009069:Movement Disorders / Q000209:etiology / Q000628:therapy*; D012189:Retrospective Studies; D013238:Stereotaxic Techniques; D013787:Thalamic Nuclei / Q000601:surgery*
Intérêts de la destruction stéréotaxique bifocale en cas de dyskinésies chez des patients ayant une infirmité motrice d'origine cérébrale.