Micrographia induced by pallidal DBS for segmental dystonia: a subtle sign of hypokinesia?
Recently parkinsonism has been reported as a rare side effect of globus pallidus internus (GPi) deep brain stimulation (DBS) for dystonia. In the present systematic prospective study in 11 patients with segmental dystonia not affecting distal arm function, we could demonstrate significant changes in handwriting characterized by mild micrographia following GPi-DBS. We propose that this finding reflects GPi-DBS-induced disturbances of basal ganglia function in terms of a mild hypokinetic syndrome, as a result of outflow alterations in pallido-thalamo-cortical pathways.
Department of Neurology, Universitaetsmedizin Mannheim, UMM, University of Heidelberg, Theodor-Kutzer Ufer 1-3, 68167, Mannheim, Germany. c.blahak@neuro.ma.uni-heidelberg.de
Christian
C
Blahak
Hans-Holger
HH
Capelle
Hansjoerg
H
Baezner
Thomas M
TM
Kinfe
Michael G
MG
Hennerici
Joachim K
JK
Krauss
D000368:Aged; D046690:Deep Brain Stimulation / Q000009:adverse effects* / Q000379:methods; D020821:Dystonic Disorders / Q000503:physiopathology* / Q000601:surgery*; D005260:Female; D005917:Globus Pallidus / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D018476:Hypokinesia / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000209:etiology*
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