| The Thalamotomy and Pallidotomies for Dystonia |
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Byung Chul Son |
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Department of Neurosurgery, St Vincent's Hospital, The Catholic University of Korea, Suwon, Korea |
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| Abstract |
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Dystonia is a movement disorder characterized by sustained muscle contractions, leading to twisting, repetitive movements and abnormal postures. Both lesions of basal ganglia and thalamus have been reported to be the cause of the dystonia. The alteration
in the neural activity in the pallidothalamocortical and cerebellothalamocortical circuits seems to be the pathophysiologic mechanism of dystonia. However, the particular changes in neural activity in the circuits and their relationships to the development of dystonia is unclear. Patients with generalized or focal dystonia, either primary or secondary, have been considered candidates for stereotactic thalamotomies and pallidotomies. Although all groups of patients have been reported to benefit from ablative procedures in both the thalamus and pallidum. To date, no randomized trials comparing either the site (pallidum or thalamus) or technique (ablative versus stimulation) have been conducted. Further studies are needed with careful characterization of patients into focal, segmental, hemi- and generalized dystonia to document carefully which patient populations respond best to the various surgical treatment. |
| Key Words:
Dystonia, Thalamotomy, Pallidotomy. |
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