Fifty years of brain surgery for dystonia: revisiting the Irving S. Cooper's legacy, and looking forward.
As dystonia may represent a severe disease with possible fatal outcome or physical or social incapacity, and considering the limited efficacy of drug treatments (excepted doparesponsive dystonia), efforts have been made since the 1950s to propose alternative treatment. In this paper, an overview of the works done by neurosurgeons over fifty years to treat severe dystonia is presented. In this area of therapeutical research, the pioneering contribution of Irving Cooper is presented and discussed, and the way his publications were evaluated emphasized. Undoubtedly, Cooper observed striking improvement after performing basal ganglia lesions in patients with generalized dystonia, even in the long term. It should be noted that he early made almost the same statements as today's preliminary observations regarding the clinical criteria for the selection of good responders to brain functional surgery. However, the message was lost, given the amount of critics Cooper received, and probably, the way he required to present them. This point emphasize the need we are today to carry out carefully designed, controlled, double-blind studies in this area.
Vercueil
Laurent
L
Neurological Department, Grenoble University Hospital, Grenoble, France. LVercueil@chu-grenoble.fr
D001921:Brain / Q000601:surgery*; D004421:Dystonia / Q000266:history* / Q000601:surgery*; D049673:History, 20th Century