title: Effectiveness of unilateral pallidotomy for meige syndrome confirmed by motion analysis.
abstract: BACKGROUND
  We report the case of a 64-year-old woman with bilateral manifestation of Meige syndrome (MS) successfully treated with left-side unilateral ventroposterolateral pallidotomy.
  
  
  METHODS
  Symptoms were evaluated according to the Burke-Fahn-Marsden dystonia rating scale. Head tremor, blepharospasm and orofacial dyskinesia were measured with an infrared, video-based, computerized, real-time passive marker-based analyzer of motions (RTPAM).
  
  
  RESULTS
  The Burke-Fahn-Marsden score showed a 90.2% reduction (from 25.5 to 2.5) at 6 months, and an 88.2% long-lasting benefit (to 3.0) at the 3-year follow-up with good bilateral control of the blepharospasm and orofacial movements. The RTPAM showed a substantial regression of acceleration for all markers, and abolishment of the 4.8-Hz head tremor. The correlation between symmetrical markers, and between markers within the right and left sides, was significantly decreased.
  
  
  CONCLUSIONS
  Pallidotomy with staged procedure is recommended for the treatment of MS in patients on whom deep brain stimulation could not be performed. In case of good bilateral benefits from the unilateral procedure, contralateral surgery is not needed. The RTPAM is a useful tool for the mapping of facial involuntary movements.
authors.affiliation: Department of Neurosurgery, St. John's Hospital, Budapest, Hungary. valalik@parkinson.hu
authors.forename: István
authors.initials: I
authors.lastname: Valálik
authors.forename: Akos
authors.initials: A
authors.lastname: Jobbágy
authors.forename: László
authors.initials: L
authors.lastname: Bognár
authors.forename: András
authors.initials: A
authors.lastname: Csókay
mesh_terms: D005260:Female; D005917:Globus Pallidus / Q000601:surgery*; D006801:Humans; D008538:Meige Syndrome / Q000601:surgery*; D008875:Middle Aged; D053860:Pallidotomy / Q000379:methods*; D013238:Stereotaxic Techniques; D016896:Treatment Outcome