Background

Dystonia is a movement disorder associated with significant disability and is usually refractory to medical treatment. Pallidotomy may decrease dystonic movements. The aim of this study was to quantify movement and disability improvements through Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS).

Methods

We carried out a longitudinal clinical study in patients with refractory primary and secondary dystonia, who underwent radiofrequency (RF) unilateral and bilateral lesions on the postero-ventro-lateral globus pallidus internus (GPi), evaluating the outcomes through BFMDRS and variables as age, time of evolution, etiology, body distribution, planned target coordinates, and lesion size, during a mean follow-up time of 35.67 months.

Results

Nine RF pallidotomies were performed on 6 patients, 7 right-sided and 2 left-sided; three patients were treated unilaterally for one occasion, while the others underwent 2 surgeries, including one staged bilateral procedure. Mean BFMDRS scores for movement were 38.5 preoperative and 25.5 postoperative, and for disability were 20.4 preoperative and 17.3 postoperative. We noticed improvement in movement (32.54%, p = 0.001) and disability (17.23%, p = 0.002). There was one right GPi and internal capsule (IC) infarction with contralateral hemiparesis as sequelae.

Conclusions

RF pallidotomy is an effective and accessible procedure to reduce BFMDRS scores in refractory dystonia if patients are correctly selected by severity, evolution, and disability as determining factors.

中文翻译：

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Burke-Fahn-Marsden 肌张力障碍评定量表中特定的运动和残疾改善，该量表源自对难治性患者的苍白切开术到药物治疗

背景

肌张力障碍是一种与严重残疾相关的运动障碍，通常对药物治疗无效。苍白球切开术可减少肌张力障碍运动。本研究的目的是通过 Burke-Fahn-Marsden 肌张力障碍评定量表 (BFMDRS) 量化运动和残疾的改善。

方法

我们对患有难治性原发性和继发性肌张力障碍的患者进行了一项纵向临床研究，这些患者在后腹外侧苍白内球 (GPi) 上接受了射频 (RF) 单侧和双侧病变，通过 BFMDRS 和年龄等变量评估结果，在 35.67 个月的平均随访时间内，进化时间、病因、身体分布、计划目标坐标和病变大小。

结果

6 例患者进行了 9 次射频苍白球切开术，其中 7 例右侧和 2 例左侧；3名患者接受了一次单侧治疗，其他患者接受了2次手术，其中包括1次分期双侧手术。运动的平均 BFMDRS 评分为术前 38.5 分和术后 25.5 分，残疾评分为术前 20.4 分和术后 17.3 分。我们注意到运动（32.54%，p = 0.001）和残疾（17.23%，p = 0.002）的改善。有 1 例右侧 GPi 和内囊 (IC) 梗塞伴对侧偏瘫为后遗症。

结论

如果根据严重程度、演变和残疾作为决定因素正确选择患者，RF 苍白球切开术是一种有效且易于操作的程序，可降低难治性肌张力障碍患者的 BFMDRS 评分。