• World Neurosurg · May 2016

    Case Reports

    Bilateral pallidotomy for cervical dystonia after failed selective peripheral denervation.

    • Shiro Horisawa, Shinichi Goto, Nobuhiko Takeda, Hanae Terashima, Takakazu Kawamata, and Takaomi Taira.
    • Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo, Japan.
    • World Neurosurg. 2016 May 1; 89: 728.e1-4.

    BackgroundWe investigated the utility of pallidotomy for cervical dystonia after failed selective peripheral denervation.Case DescriptionA 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.ConclusionsPallidotomy represents a feasible and effective treatment for cervical dystonia refractory to selective peripheral denervation without hardware-related complications.Copyright © 2016 Elsevier Inc. All rights reserved.

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