Poststroke fixed dystonia of the foot relieved by chronic stimulation of the posterior limb of the internal capsule.
The authors report the case of an adult patient with irreducible fixed dystonia (inward rotation) of the right foot that arose after cardioembolic ischemia of the left putamen and globus pallidus externus. Given the resistance of such symptomatology to all of the attempted conservative treatments (including botulinum toxin), the authors decided to perform deep brain stimulation, positioning the intracerebral electrode in the left internal capsule at the level of the motor fibers controlling the right foot, as confirmed by intraoperative electromyography. After the intervention, the patient was able to perform voluntary movements of outward rotation and abduction in the right foot and begin gait rehabilitation. Deep brain stimulation of the posterior limb of the internal capsule could be an alternative target used to treat poststroke fixed dystonic conditions.
Franzini
Angelo
A
Istituto Neurologico Carlo Besta, Milan, USA.
Messina
Giuseppe
G
Marras
Carlo
C
Molteni
Franco
F
Cordella
Roberto
R
Soliveri
Paola
P
Broggi
Giovanni
G
D000328:Adult; D002545:Brain Ischemia / Q000150:complications / Q000473:pathology; D046690:Deep Brain Stimulation; D004421:Dystonia / Q000209:etiology* / Q000473:pathology / Q000628:therapy*; D004567:Electrodes, Implanted; D005260:Female; D005528:Foot / Q000473:pathology; D006801:Humans; D020772:Internal Capsule / Q000473:pathology; D020521:Stroke / Q000150:complications* / Q000473:pathology; D016896:Treatment Outcome