Pallidal high-frequency deep brain stimulation for camptocormia: an experience of three cases

Fukaya, Chikashi; Otaka, Toshiharu; Obuchi, Toshiki; Kano, Toshikazu; Nagaoka, Toshinori; Kobayashi, Kazuhiko; Oshima, Hideki; Yamamoto, Takamitsu; Katayama, Yoichi

doi:10.1007/978-3-211-35205-2_4

Cited by 25 publications

(27 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In single cases in which camptocormia is associated with Parkinson’s disease or segmental dystonia, bilateral pallidal high-frequency deep brain stimulation [62,78,79] or bilateral subthalamic nucleus stimulation [80,81] may have a beneficial effect. The therapeutic effect of deep brain stimulation suggests that, at least in single cases, camptocormia is indeed a CNS disease due to affection of the striatum and its reticulospinal and thalamic projections [27].…”

Section: Treatmentmentioning

confidence: 99%

“…Arguments for a PNS origin of camptocormia in Parkinson’s disease are that axial muscles may show myopathic features on EMG or muscle biopsy [1] and that MRI of the axial muscles may show atrophy and fatty replacement of the thoracolumbar muscles [33]. CNS disorders associated with camptocormia in addition to Parkinson’s disease include MSA [2,34,35], Alzheimer’s disease [36], basal ganglia disorders [14], and abdominal segmental dystonia [37]. Because of the frequent association of camptocormia with Parkinson’s disease [3,19] or dystonias [28], some authors regard camptocormia even a segmental form of dystonia [14,38].…”

Section: Etiologymentioning

confidence: 99%

See 1 more Smart Citation

Presentation, Etiology, Diagnosis, and Management of Camptocormia

Finsterer

Strobl

2010

Eur Neurol

View full text Add to dashboard Cite

Camptocormia (bent spine syndrome, cyphose hystérique) is an abnormality characterized by severe forward flexion of the thoracolumbar spine which typically increases during walking or standing and completely disappears in supine position. Camptocormia can be due to central nervous system diseases, such as Parkinson’s disease, dystonia, multisystem atrophy, or Alzheimer’s disease, due to peripheral nervous system diseases, such as primary myopathy, secondary myopathy, motor neuron disease, myasthenia, or chronic inflammatory demyelinating polyneuropathy, due to side effects of drug treatment, due to disc herniation, arthritis or spinal trauma, or due to paraneoplasia. Only rarely may camptocormia be attributable to psychiatric disease. The diagnosis is based on clinical findings, imaging of the cerebrum or spine, needle electromyography, or muscle biopsy. Treatment options are limited and frequently futile and rely on conservative measures, such as psychotherapy, physiotherapy, use of orthoses, drugs, injection of botulinum toxin, withdrawal of causative drugs, electroconvulsive therapy, or invasive measures, such as surgical correction or deep brain stimulation. The outcome is generally fair. Some patients profit from therapy whereas others do not respond to treatment and become progressively immobile.

show abstract

Section: Treatmentmentioning

confidence: 99%

Section: Etiologymentioning

confidence: 99%

Presentation, Etiology, Diagnosis, and Management of Camptocormia

Finsterer

Strobl

2010

Eur Neurol

View full text Add to dashboard Cite

show abstract

“…Many possible causes of camptocormia have been reported, including muscle rigidity and dystonia in the abdomen, proprioceptive deficits, adverse effects of dopamine agonists, soft tissue imbalance, and fatty degeneration and myopathy in the back muscles, but details remain unclear [7]. Although there is no effective curative therapy, several symptomatic therapies are reported to be effective, including dosage of oral carbidopa/levodopa or dopamine agonists, botulinum toxin injections, and DBS [3,[8][9][10][11]. Meanwhile, pain in the low back and legs is common in Parkinson's disease, with a prevalence of approximately 40-85% [3].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of spinal cord stimulation for painful camptocormia with Pisa syndrome in Parkinson’s disease: a case report

et al. 2017

View full text Add to dashboard Cite

Background: Spinal cord stimulation (SCS) has recently been reported to be effective for truncal postural abnormalities such as camptocormia and Pisa syndrome in Parkinson's disease. In this case report, we describe a case of a woman with Parkinson's disease in whom SCS was effective for painful camptocormia with Pisa syndrome. Case presentation: A 65-year-old woman was admitted to our hospital because of painful camptocormia. She had noticed resting tremor in the left upper limb and aprosody at 48 years of age. She was diagnosed as having Parkinson's disease (Hoehn & Yahr stage 1) at 53 years of age. Cabergoline was started during that same year, with subsequent addition of selegiline hydrochloride; the symptoms of parkinsonism disappeared. Wearing-off occurred when she was 57 years old, 3 years after starting carbidopa/levodopa, and truncal postural abnormalities-painful camptocormia with Pisa syndrome to the right-appeared at 58 years of age. These symptoms worsened despite adjustment of her oral medications, and deep brain stimulation (DBS) was performed when she was 60 years old. The truncal postural abnormalities improved after DBS, and she could travel abroad at 61 years of age. However, from 62 years of age, painful camptocormia with Pisa syndrome to the right reappeared. The pain was unsuccessfully treated with oral analgesics, radiofrequency coagulation of the dorsal and medial branches of the lumbar spinal nerve, and lumbar epidural block. Finally, SCS was performed for the pain relief. The pain disappeared immediately after SCS and her posture then gradually improved. Unified Parkinson's Disease Rating Scale score improved from 48 to 34 points and Timed Up and Go Test improved from 15 s to 7 s after SCS. Conclusions: This case suggests that SCS may be effective for improving painful truncal postural abnormalities and motor complications of Parkinson's disease. Pain relief or a direct effect on the central nervous system by SCS was considered to explain the alleviation of these symptoms.

show abstract

“…Deep brain stimulation has also been reported to improve camptocormia associated with other movement disorders. Fukaya et al 13 reported improvement of camptocormia in 3 patients with primary dystonia who underwent placement of bilateral GPi DBS. Nandi et al 24 published a case report of a patient with tardive dyskinesia and camptocormia who responded to the placement of bilateral GPi electrodes for DBS.…”

Section: Camptocormiamentioning

confidence: 99%

Spinal deformity and Parkinson disease: a treatment algorithm

Upadhyaya¹,

Starr²,

Mummaneni³

2010

FOC

View full text Add to dashboard Cite

Object The authors review the literature on the treatment of spinal deformity in patients with Parkinson disease (PD) and formulate a treatment algorithm. Methods The authors provide representative cases of patients with PD and spinal deformity who underwent deep brain stimulation (DBS) or spinal surgery. Results In patients with PD and spinal deformity who undergo spinal surgery there is a high rate of acute and delayed complications. Patients who undergo DBS, while having significantly fewer complications, often do not regain sagittal balance. Conclusions Cases involving PD and camptocormia have a high rate of complications when spinal surgery is performed. The authors prefer to offer spinal surgery only to patients with coexisting spinal stenosis causing radiculopathy or myelopathy. Patients with PD and camptocormia without spinal stenosis may be considered for DBS, but the results are mixed.

show abstract

Pallidal high-frequency deep brain stimulation for camptocormia: an experience of three cases

Cited by 25 publications

References 8 publications

Presentation, Etiology, Diagnosis, and Management of Camptocormia

Presentation, Etiology, Diagnosis, and Management of Camptocormia

Effectiveness of spinal cord stimulation for painful camptocormia with Pisa syndrome in Parkinson’s disease: a case report

Spinal deformity and Parkinson disease: a treatment algorithm

Contact Info

Product

Resources

About