Functional recovery after bilateral pallidotomy for the treatment of early-onset primary generalized dystonia.
This report describes the successful treatment of dystonia musculorum deformans with bilateral stereotactic pallidotomy in a 14-year-old girl in whom the dystonia was diagnosed when she was 7 years old. The patient presented with dystonia of the right upper extremity that progressed to generalized dystonia. Preoperatively, she required maximal assistance with all activities of daily living and transfers. She was not a functional ambulator. Postoperatively, she had remarkable functional recovery. At discharge, she was at modified independence level for all basic activities of daily living and required supervision for household ambulation. No postoperative complications were noted. We propose that bilateral stereotactic lysis of globus pallidus interna may be an alternative treatment for dystonia musculorum deformans. The technique of bilateral pallidotomy and theories of its effectiveness are discussed.
Lai
T
T
Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA.
Lai
J M
JM
Grossman
R G
RG
D000203:Activities of Daily Living; D000293:Adolescent; D017668:Age of Onset; D018450:Disease Progression; D004422:Dystonia Musculorum Deformans / Q000235:genetics / Q000503:physiopathology / Q000534:rehabilitation* / Q000601:surgery*; D005260:Female; D005917:Globus Pallidus / Q000601:surgery*; D006801:Humans; D018579:Patient Selection; D020127:Recovery of Function; D013238:Stereotaxic Techniques / Q000009:adverse effects / Q000534:rehabilitation*; D016896:Treatment Outcome; D016138:Walking