Stereotactic and functional neurosurgery
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Stereotact Funct Neurosurg · Jan 2012
Microelectrode recording duration and spatial density constraints for automatic targeting of the subthalamic nucleus.
Accurate detection of the boundaries of the subthalamic nucleus (STN) in deep brain stimulation (DBS) surgery using microelectrode recording (MER) is considered to refine localization and may therefore improve clinical outcome. However, MER tends to extend operation time and its cost-utility balance has been debated. ⋯ STN entry detection error was about half of the step size. Sampling duration of STN activity can be minimized to 1 s/record without compromising accuracy. We conclude that bilateral DBS surgery time utilizing MER may be significantly shortened without compromising targeting accuracy.
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Stereotact Funct Neurosurg · Jan 2012
Rechargeable deep brain stimulators in the management of paediatric dystonia: well tolerated with a low complication rate.
Deep brain stimulation (DBS) is a recognised method of treatment for primary and secondary dystonia. The size of non-rechargeable batteries has limited their use in small children. Our severe dystonia patients have required battery replacement every 20-24 months. ⋯ Activa was found to offer reliable stimulation with a low rate of significant complications and a suitable treatment option for children with dystonia.
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Stereotact Funct Neurosurg · Jan 2012
Case ReportsGamma knife radiosurgery for recurrent glossopharyngeal neuralgia after microvascular decompression.
We report the first application of Gamma Knife radiosurgery (GKR) for recurrent glossopharyngeal neuralgia (GN) after microvascular decompression (MVD). The patient is a 51-year-old male with left-sided GN. He underwent MVD and did well for almost 4 years. Later on, the patient started to experience recurrent intolerable throat pain, frequently 10/10 in intensity. Based on the application of radiosurgery for trigeminal neuralgia, GKR was offered to the patient. ⋯ GKR, which is now widely used for refractory trigeminal neuralgia, can be considered for refractory or recurrent GN. With a multidisciplinary approach and advanced neuroimaging, GKR is feasible for GN after MVD, despite the shortness of the intracranial cisternal nerve portion. Further studies are necessary to establish the role of GKR for refractory GN after MVD; however, given its rarity and the lack of experience with GKR for this condition, retrospective studies with dozens of patients are almost impossible at this time.
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Stereotact Funct Neurosurg · Jan 2012
Weight change after globus pallidus internus or subthalamic nucleus deep brain stimulation in Parkinson's disease and dystonia.
Weight gain has been described in Parkinson's disease (PD) patients after subthalamic nucleus (STN) deep brain stimulation (DBS). ⋯ Our results support previous reports of weight gain after DBS in PD. This is the first report to suggest a target-specific increase in weight following STN DBS in dystonia patients.