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

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

World Neurosurg. 2018 Apr 18;:

Authors: Takeda N, Hoeisawa S, Taira T, Kawamata T

Abstract
BACKGROUND: Deep brain stimulation (DBS) is an established treatment for generalized dystonia. However, the DBS device is sometimes removed owing to hardware complications. Here, we present four cases of generalized dystonia treated with radiofrequency lesioning through the DBS electrodes.
CASE DESCRIPTION: The patients were three men and one woman (34 to 44 years old). They had undergone DBS for generalized dystonia. However, they subsequently developed complications, such as infection, and removal of the devices became necessary. 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: two patients had bilateral pallidotomy, one patient had unilateral pallidotomy, and one patient had pallidotomy and ipsilateral thalamotomy. As a result, in four patients, the dystonic symptoms did not worsen even after removal of the DBS systems during a follow-up period of 1 to 12 years. However, one patient had a small hemorrhage and two 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.

PMID: 29679783 [PubMed - as supplied by publisher]

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