Dystonia: a surgeon's perspective. 2009

Tipu Z Aziz, and Alexander L Green
Department of Neurosurgery, The John Radcliffe Hospital, Oxford, UK. tipu.aziz@nds.ox.ac.uk

Surgery for dystonia has a history stretching back for centuries including myotomy and other procedures on the musculoskeletal system. In the last century lesional procedures, mainly involving the pallidum became popular. More recently, with the advent of deep brain stimulation, bilateral medial pallidal stimulation has become commonplace. This review describes the issues with patient selection, technical aspects of implantation and effects as well as complications of the technique. Some of the rarer types of dystonia that have also been treated with DBS are also described.

UI MeSH Term Description Entries
D004421 Dystonia An attitude or posture due to the co-contraction of agonists and antagonist muscles in one region of the body. It most often affects the large axial muscles of the trunk and limb girdles. Conditions which feature persistent or recurrent episodes of dystonia as a primary manifestation of disease are referred to as DYSTONIC DISORDERS. (Adams et al., Principles of Neurology, 6th ed, p77) Muscle Dystonia,Dystonia, Diurnal,Dystonia, Limb,Dystonia, Paroxysmal,Diurnal Dystonia,Dystonia, Muscle,Limb Dystonia,Paroxysmal Dystonia
D004567 Electrodes, Implanted Surgically placed electric conductors through which ELECTRIC STIMULATION is delivered to or electrical activity is recorded from a specific point inside the body. Implantable Electrodes,Implantable Stimulation Electrodes,Implanted Electrodes,Implanted Stimulation Electrodes,Electrode, Implantable,Electrode, Implantable Stimulation,Electrode, Implanted,Electrode, Implanted Stimulation,Electrodes, Implantable,Electrodes, Implantable Stimulation,Electrodes, Implanted Stimulation,Implantable Electrode,Implantable Stimulation Electrode,Implanted Electrode,Implanted Stimulation Electrode,Stimulation Electrode, Implantable,Stimulation Electrode, Implanted,Stimulation Electrodes, Implantable,Stimulation Electrodes, Implanted
D005917 Globus Pallidus The representation of the phylogenetically oldest part of the corpus striatum called the paleostriatum. It forms the smaller, more medial part of the lentiform nucleus. Paleostriatum,Pallidum,Pallidums
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D046690 Deep Brain Stimulation Therapy for MOVEMENT DISORDERS, especially PARKINSON DISEASE, that applies electricity via stereotactic implantation of ELECTRODES in specific areas of the BRAIN such as the THALAMUS. The electrodes are attached to a neurostimulator placed subcutaneously. Brain Stimulation, Deep,Electrical Stimulation of the Brain,Brain Stimulations, Deep,Deep Brain Stimulations,Stimulation, Deep Brain,Stimulations, Deep Brain
D018832 Molecular Chaperones A family of cellular proteins that mediate the correct assembly or disassembly of polypeptides and their associated ligands. Although they take part in the assembly process, molecular chaperones are not components of the final structures. Chaperones, Molecular,Chaperone, Molecular,Molecular Chaperone

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