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Functional Neurosurgery for Secondary Dystonia: Indications and Long-Term Results

  • Jairo Alberto Espinoza MartinezEmail author
  • Oscar Andres Escobar Vidarte
  • Gabriel Arango Uribe
Conference paper
Part of the Acta Neurochirurgica Supplement book series (NEUROCHIRURGICA, volume 117)

Abstract

Dystonia is a movement disorder characterized by patterned, repetitive, phasic, or tonic sustained muscle contractions that produce abnormal, often twisting, postures or repetitive movements. When the disorder is genetic or the cause is unknown and dystonia is the sole feature, the disease is called primary or idiopathic, conversely secondary dystonia (SD) may be caused by various brain insults. Both primary dystonia and SD have been notorious for their poor response to medical treatment. Today, stereotactic neurosurgical procedures are offered to improve the disability and quality of life of patients who do not respond to medical therapy. However, SD shows less and more variable results than primary dystonia to neurosurgical procedures, the benefits of ablative or deep brain stimulation (DBS) procedures in basal structures being still subject to debate and much harder to fully appreciate. In this work, the authors show a 33-patient series with secondary dystonia, separating the statistic and clinical analysis into several etiology groups: perinatal insults, tardive syndromes, genetic syndromes, and posttraumatic. In these groups, we show the mean BFM score improvement in the different patient series, comparing our results with world literature, and finally propose a classification system for bettering the clinical approach in surgery decision when this is indicated.

Keywords

Secondary dystonia Deep brain stimula-tion Intrathecal baclofen Brain motor circuits 

Notes

Conflict of Interest

We declare that we have no conflict of interest.

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Copyright information

© Springer-Verlag Wien 2013

Authors and Affiliations

  • Jairo Alberto Espinoza Martinez
    • 1
    • 2
    • 3
    Email author
  • Oscar Andres Escobar Vidarte
    • 1
    • 2
    • 3
  • Gabriel Arango Uribe
    • 1
    • 2
    • 3
  1. 1.Movement Disorders and Pain Management Center, CIMADBogotaColombia
  2. 2.Marly ClinicBogotaColombia
  3. 3.San Jose Children’s HospitalBogotaColombia

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