title: Camptocormia treated with bilateral pallidal stimulation: case report.
abstract: The authors report the neurological, neurophysiological, and neuropsychological effects of using chronic bilateral pallidal high-frequency deep brain stimulation (DBS) in a case of disabling camptocormia. Deep brain stimulation electrodes were implanted stereotactically to target the globus pallidus internus (GPi) bilaterally. Local field potentials (FPs) were recorded using the DBS electrodes and concurrent abdominal flexor electromyography (EMG) potentials during camptocormic episodes. Videotaped assessments of the movement disorder and neuropsychological evaluation before implantation and at 6 months after initiation of pallidal stimulation were recorded. There was significant functional improvement following chronic pallidal stimulation, and some improvement was noted in neuropsychological scores. The GPi FPs showed temporal correlation with EMG-recorded rectus abdominis potentials. There were no treatment-related adverse effects. The authors have found that chronic pallidal stimulation was safe and offered functional benefit in this severely disabling condition. The physiological studies may help further the understanding of the pathophysiology of this rare entity.
authors.affiliation: Laboratory of Physiology, University of Oxford, Oxford, United Kingdom.
authors.forename: Dipankar
authors.initials: D
authors.lastname: Nandi
authors.forename: Simon
authors.initials: S
authors.lastname: Parkin
authors.forename: Richard
authors.initials: R
authors.lastname: Scott
authors.forename: Jonathan L
authors.initials: JL
authors.lastname: Winter
authors.forename: Carole
authors.initials: C
authors.lastname: Joint
authors.forename: Ralph
authors.initials: R
authors.lastname: Gregory
authors.forename: John
authors.initials: J
authors.lastname: Stein
authors.forename: Tipu Z
authors.initials: TZ
authors.lastname: Aziz
mesh_terms: D000009:Abdominal Muscles / Q000503:physiopathology*; D000328:Adult; D046690:Deep Brain Stimulation / Q000379:methods*; D004421:Dystonia / Q000175:diagnosis / Q000503:physiopathology*; D005917:Globus Pallidus / Q000000981:diagnostic imaging / Q000502:physiology*; D006801:Humans; D008297:Male; D011859:Radiography; D013035:Spasm / Q000175:diagnosis / Q000503:physiopathology