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Full recovery from drummer’s dystonia with foot and arm symptoms after stereotactic ventro-oral thalamotomy: a case report

  • Case Report - Functional
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Abstract

Ventro-oral (Vo) thalamotomy is effective in patients with focal task-specific dystonias (FTSDs), but only in those with upper-limb symptoms. We describe a patient with drummer’s dystonia who completely recovered after Vo thalamotomy. A 37-year-old man who started playing drums at 14 began having difficulty performing fine movements with his right foot when drumming at 22. He experienced right hand cramps while drumming 3 months before visiting our hospital. He was diagnosed with FTSD. Left Vo thalamotomy was performed, which led to complete improvement of symptoms. Vo thalamotomy may be effective for FTSD patients with upper- and lower-extremity symptoms.

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Authors and Affiliations

  1. Department of Neurosurgery, Kanazawa Neurosurgical Hospital, 262-2 Go-machi, Nonoichi-shi, Ishikawa, 921-8841, Japan

    Takashi Asahi, Kiyonobu Ikeda, Jiro Yamamoto & Shuji Sato

  2. Department of Neurosurgery, Tokyo Women’s Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan

    Takaomi Taira

Authors
  1. Takashi Asahi
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  2. Takaomi Taira
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  3. Kiyonobu Ikeda
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  4. Jiro Yamamoto
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  5. Shuji Sato
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Corresponding author

Correspondence to Takashi Asahi.

Ethics declarations

This study was approved by the Ethics Committee of Kanazawa Neurosurgical Hospital (ID 28-04).

Conflict of interest

The authors declare that they have no conflict of interest.

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Informed consent was obtained from the participant included in this report.

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Comments

This well-written report on the benefit of thalamotomy in a case of drummer’s dystonia is elucidating. My guess is that most colleagues nowadays would have selected Deep Brain Stimulation (DBS) as their procedure of choice to treat such cases, but the authors argue rather convincingly that a thalamotomy procedure has some advantages over DBS: a lasting, perhaps life-long effect is not dependent on costly hardware that hardly can be expected to last for the rest of the usually young person’s life and it is not associated with an increased infection risk. There are also several other advantages, as listed by the authors in their discussion. I believe their choice of method is right for this young patient.

Knut Wester

Bergen, Norway

Electronic supplementary material

Video 1

Video clip demonstrating the effects of ventro-oral thalamotomy for the treatment of drummer’s dystonia. The clip is divided into three parts. Part 1 (1–19 s) shows the patient’s symptoms when playing the drums before thalamotomy. Part 2 (19–59 s) shows the surgery being performed with the patient under local anesthesia. Part 3 (59–72 s) shows the patient 4 months after the surgery. The patient was able to play the drums without any discomfort at this time (MP4 21,662 kb)

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Asahi, T., Taira, T., Ikeda, K. et al. Full recovery from drummer’s dystonia with foot and arm symptoms after stereotactic ventro-oral thalamotomy: a case report. Acta Neurochir 160, 835–838 (2018). https://doi.org/10.1007/s00701-018-3480-5

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  • DOI: https://doi.org/10.1007/s00701-018-3480-5

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