Radiofrequency Lesioning Through Deep Brain Stimulation Electrodes in Patients with Generalized Dystonia.

Abstract

BACKGROUND:

Deep brain stimulation (DBS) is an established treatment for generalized dystonia. However, the DBS device is sometimes removed owing to hardware complications. We present 4 cases of generalized dystonia treated with radiofrequency lesioning through DBS electrodes.

CASE DESCRIPTION:

Four patients, 3 men and 1 woman (age range, 34-44 years), underwent DBS for generalized dystonia and subsequently developed complications, such as infection, necessitating removal of the devices. As stopping the stimulation caused recurrence of uncontrollable symptoms, radiofrequency lesioning was performed through the DBS electrodes under local anesthesia, and the DBS systems were removed under local or generalized anesthesia thereafter. The procedures performed were as follows: 2 patients had bilateral pallidotomy, 1 patient had unilateral pallidotomy, and 1 patient had pallidotomy and ipsilateral thalamotomy. As a result, in 4 patients, the dystonic symptoms did not worsen even after removal of the DBS systems during a follow-up period of 1-12 years. However, 1 patient had a small hemorrhage, and 2 patients showed recurrence of dystonia.

CONCLUSIONS:

Radiofrequency lesioning with DBS electrodes is feasible in cases of generalized dystonia when the DBS leads have to be removed.

• Authors: Nobuhiko Takeda, Shiro Horisawa, Takaomi Taira, Takakazu Kawamata
• Journal: World neurosurgery (World Neurosurg) Vol. 115 Pg. 220-224 (Jul 2018) ISSN: 1878-8769 [Electronic] United States
• PMID: 29679783 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2018 Elsevier Inc. All rights reserved.

Topics

• Adult
• Deep Brain Stimulation (instrumentation, methods, trends)
• Dystonia (diagnostic imaging, therapy)
• Electrodes, Implanted (trends)
• Female
• Follow-Up Studies
• Humans
• Male
• Pulsed Radiofrequency Treatment (instrumentation, methods, trends)