Stereotactic and functional neurosurgery
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Twiddler's syndrome describes the intentional external manipulation or spontaneous rotation of implanted devices such as cardiac pacemakers. Here we report the same phenomenon occurring in a patient with an implanted deep brain stimulator generator. The clinical syndrome is described and potential technical nuances to prevent its occurrence are suggested.
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Stereotact Funct Neurosurg · Jan 2008
Comparative StudyBrain shift during deep brain stimulation surgery for Parkinson's disease.
Brain shift may occur during deep brain stimulation (DBS) surgery, which may affect the position of subcortical structures, compromising target localization. ⋯ Subcortical structures shift during DBS surgery. This shift appears to be gravity-dependent since structures only shifted posteriorly, and patients were primarily in the supine position. Posterior shift of RN may indicate STN displacement. Such positional change may compromise target localization, requiring multiple microelectrode adjustments. This may provide indirect justification for the necessity of microelectrode recordings during DBS surgery.
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Stereotact Funct Neurosurg · Jan 2008
Comparative StudyStereotactic MRI in DYT1 dystonia: focal signal abnormalities in the basal ganglia do not contraindicate deep brain stimulation.
To study stereotactic magnetic resonance imaging (MRI) features of the basal ganglia in DYT1 primary dystonia. ⋯ T(1)-hypointense/T(2)-hyperintense signal abnormalities are common findings in the putamen and globus pallidus of DYT1 patients but do not contraindicate DBS. However, their presence within the GPi may reduce the efficacy of DBS treatment.
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Stereotact Funct Neurosurg · Jan 2008
Comparative StudySubthalamic stimulation for essential tremor. Short- and long-term results and critical target area.
In order to explore the usefulness and long-term result of subthalamic nucleus (STN) stimulation for the treatment of essential tremor (ET), we evaluated 3 groups of patients undergoing deep brain stimulation (DBS) for ET. ⋯ Provided that intra-operative test stimulation produces satisfactory tremor control, STN is a good target for long-term treatment of ET. For patients above the age of 70 years, however, the Vim is a preferable target.