title: Pallidal stimulation for medically intractable blepharospasm.
abstract: Deep brain stimulation (DBS) of the globus pallidus internus (GPi) is an established procedure to improve generalised, segmental craniofacial dystonia. However, no studies have addressed the applicability of DBS for blepharospasm as a focal craniofacial dystonia. A 52-year-old man developed medically intractable involuntary eye closure. Because the abnormal movement was observed exclusively in the eyelids, he was diagnosed not with Meige's syndrome but with blepharospasm as a focal craniofacial dystonia. He underwent stereotactic surgery under general anaesthesia for bilateral GPi-DBS. Continuous GPi stimulation almost completely abolished the blepharospasm. 15 months after the operation, his preoperative scores on the Burke-Fahn-Marsden Dystonia Rating Scale (=8 points) decreased to 1 (87.5% improvement). The present study demonstrates the applicability of GPi-DBS for treating blepharospasm presenting as focal dystonia. Further studies with accumulated case series are needed to confirm the effect of DBS on blepharospasm and other focal craniofacial dystonias.
authors.affiliation: Department of Functional Neurosurgery, Kumamoto University Hospital, Kumamoto, Japan.
authors.forename: Kazumichi
authors.initials: K
authors.lastname: Yamada
authors.affiliation: Department of Functional Neurosurgery, Kumamoto Daigaku Igakubu Fuzoku Byoin, Kumamoto, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Shinojima
authors.affiliation: Department of Neurosurgery, Kumamoto Daigaku Igakubu Fuzoku Byoin, Kumamoto, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Hamasaki
authors.affiliation: Department of Neurosurgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Kuratsu
mesh_terms: D001764:Blepharospasm / Q000175:diagnosis / Q000628:therapy*; D046690:Deep Brain Stimulation / Q000379:methods*; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008875:Middle Aged; D013238:Stereotaxic Techniques; D016896:Treatment Outcome