title: Bilateral Pallidotomy for Cervical Dystonia After Failed Selective Peripheral Denervation.
abstract: BACKGROUND
  We investigated the utility of pallidotomy for cervical dystonia after failed selective peripheral denervation.
  
  
  METHODS
  A 36-year-old man presented with cervical dystonia with limited range of motion of the left shoulder, particularly in abduction. His Tsui score was 8. Owing to the ineffectiveness of botulinum toxin injection, he underwent selective peripheral denervation with an unsatisfactory outcome, with a postoperative Tsui score of 6. Simultaneous bilateral pallidotomy was performed with local anesthesia 1 year after the initial surgery. The day after the pallidotomy, all dystonic symptoms were markedly improved except for the limited range of shoulder abduction. The Tsui score recorded 1 week after the pallidotomy was 1. Transient aggressive behavior was the only postoperative complication. During clinical follow-up period of 1 year, no recurrence of the symptoms was observed.
  
  
  CONCLUSIONS
  Pallidotomy represents a feasible and effective treatment for cervical dystonia refractory to selective peripheral denervation without hardware-related complications.
authors.affiliation: Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Horisawa
authors.affiliation: Department of Neurosurgery, Kumamoto Takumadai Rehabilitation Hospital, Kumamoto, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Goto
authors.affiliation: Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Takeda
authors.affiliation: Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Hanae
authors.initials: H
authors.lastname: Terashima
authors.affiliation: Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Takakazu
authors.initials: T
authors.lastname: Kawamata
authors.affiliation: Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo, Japan. Electronic address: ttaira@nij.twmu.ac.jp.
authors.forename: Takaomi
authors.initials: T
authors.lastname: Taira
mesh_terms: D000328:Adult; D003714:Denervation / Q000009:adverse effects*; D005917:Globus Pallidus / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D053860:Pallidotomy / Q000379:methods*; D010525:Peripheral Nerves / Q000502:physiology*; D014103:Torticollis / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome
keywords: Cervical dystonia; Deep brain stimulation; Pallidotomy; Selective peripheral denervation