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Improvement of Table Tennis Dystonia by Stereotactic Ventro-oral Thalamotomy: A Case Report.
World Neurosurg. 2017 Jan 04;:
Authors: Asahi T, Taira T, Ikeda K, Yamamoto J, Sato S
Abstract
BACKGROUND: Task-specific focal dystonia, such as writer's cramp and musician's cramp, is a type of dystonia that affects performance of particular tasks. Such movement disorders have been treated with stereotactic ventro-oral (Vo) thalamotomy, with excellent outcomes. However, there has been no previous report of treatment of sport-related/athlete's dystonia by means of stereotactic surgery. We treated a patient with table tennis-related dystonia with Vo thalamotomy, and evaluated the outcome.
CASE DESCRIPTION: A 20-year-old, female, left-handed table tennis player complained of difficulty hitting a ping-pong ball. She started playing table tennis at 8 years of age, practiced for over 4 h every day, and participated in national tournaments. Abnormal flexion of the left wrist when hitting a ball became apparent when she was aged 19 years. The abnormal movement emerged on the forehand stroke and, subsequently, on the backhand, until finally she could not continue playing. She was diagnosed with task-specific focal dystonia, which did not recover with medication. She visited our hospital and underwent right Vo thalamotomy. The surgery was performed under local anesthesia, with the patient swinging a racket during stimulation and coagulation of the thalamus. Her symptoms had improved completely the day after surgery, such that she was able to participate in tournaments again.
CONCLUSIONS: Here, we applied Vo thalamotomy for the successful treatment of athlete's dystonia, suggesting that this condition has an underlying mechanism similar to that of other task-specific focal dystonias. This provides new hope to patients with athlete's dystonia refractive to other therapies.
PMID: 28063895 [PubMed - as supplied by publisher]
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