Multitarget deep brain stimulation for clinically complex movement disorders

摘要: Deep brain stimulation (DBS) of single-target nuclei has produced remarkable functional outcomes in a number movement disorders such as Parkinson's disease, essential tremor, and dystonia. While these benefits are well established, DBS efficacy strategy for unusual, unclassified disorder syndromes is less clear. A dual pallidal thalamic electrode placement rational approach cases where there profound, medically refractory impairment. The authors report series cases: midbrain cavernoma hemorrhage with olivary hypertrophy, spinocerebellar ataxia-like probable genetic origin, Holmes tremor secondary to brainstem stroke, hemiballismus due traumatic hemorrhage, all treated by DBS. All patients demonstrated robust benefit from DBS, maintained long-term follow-up. This demonstrates the flexibility efficacy, but also limitations, thalamo-pallidal managing axial limb symptoms tremors, dystonia, chorea, complex disorders.