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Acta Neurochirurgica

, Volume 160, Issue 7, pp 1355–1358 | Cite as

An unusual surgical indication for cerebral tuberculosis: status dystonicus. Case report

  • Andrea Franzini
  • Angelo Franzini
  • Vincenzo Levi
  • Roberto Cordella
  • Giuseppe Messina
Case Report - Functional Neurosurgery - Movement disorders
  • 25 Downloads

Abstract

Actual indications for surgery in tuberculosis are limited to obtaining a diagnosis, acquiring tissue for culture studies, treating hydrocephalus, aspiring a brain abscess, and reducing intracranial pressure in patients with multiple tuberculomas. Tuberculosis-related movement disorders are usually treated pharmacologically. We report on a child affected by post-tubercular generalized dystonia, who progressed to status dystonicus (SD) and underwent stereotactic bilateral pallidotomy. After surgery, SD resolved, and drugs were rapidly tapered. The successful reversal of SD and the motor improvement observed in our patient demonstrate the safety, feasibility, and clinical efficacy of pallidotomy in post-tuberculous-meningoencephalitis dystonia and SD.

Keywords

Tuberculosis Ablative surgery Status dystonicus Pallidotomy Globus pallidus internus 

Abbreviations

SD

Status dystonicus

DBS

Deep brain stimulation

Gpi

Globus pallidus internus

FR

Firing rate

EMG

Electromyography

MRI

Magnetic resonance imaging

BFMDRS

The Burke-Fahn-Marsden dystonia rating scale

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Consent

The patient’s legal guardian has consented to submission of this case report to the journal.

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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2018

Authors and Affiliations

  • Andrea Franzini
    • 1
  • Angelo Franzini
    • 1
  • Vincenzo Levi
    • 1
  • Roberto Cordella
    • 1
  • Giuseppe Messina
    • 1
  1. 1.Department of NeurosurgeryFondazione IRCCS Istituto Neurologico Carlo BestaMilanItaly

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