Successful bilateral pallidal stimulation for Meige syndrome and spasmodic torticollis

Opherk, Christian; Gruber, Charles; Steude, U.; Dichgans, Martin; Bötzel, Kai

doi:10.1212/01.wnl.0000190257.55434.ab

Cited by 29 publications

(23 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Since Vercueil and coworkers 3 first reported their results of bilateral GPi DBS in a patient with Meige syndrome, several studies have shown that segmental dystonia responds to GPi DBS. 2,3,6,9,11,13,[18][19][20][21][22][23][24][25][29][30][31] The reports on Meige syndrome and its response to DBS are primarily single cases, aside from the excellent report by Ostrem and colleagues 25 ( Table 3). The follow-up time frame has been somewhat limited in most reports, except the cases of Loher et al 21 at 7 years, Hebb et al 11 at 5 years, and Capelle and associates 6 at 2 years.…”

Section: Discussionmentioning

confidence: 99%

“…15 Meige syndrome has become the most common eponym current used in the literature. 2,3,6,9,11,13,21,23,24,27,30 Meige syndrome is characterized by blepharospasm, cervical dystonia, and facial oromandibular dystonia. The underlying cause of Meige syndrome is unknown, but most investigators consider it a variant of idiopathic torsion dystonia.…”

mentioning

confidence: 99%

“…Stereotactic surgical ablation techniques had been used for several years with mixed results. 1,5,7,10,24,30 Both the thalamus and the GPi have been targeted. Botulinum toxin has also been shown to be effective for blepharospasm, as well as for facial, cervical, and oromandibular dystonia; however, some patients may have diminished response with time and some may develop antibodies that make them resistant to continued therapy.…”

mentioning

confidence: 99%

“…18,19,25,29,31 There have been several recent reports on the efficacy of GPi DBS in selected patients with Meige syndrome. 2,3,6,9,11,12,[21][22][23][24][25]30 We report on our experience in using DBS in 3 cases of Meige syndrome and 1 case of Parkinson disease and associated craniofacial dystonia, with long-term follow-up, and we review the current literature. Object.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Long-term follow-up of deep brain stimulation for Meige syndrome

Lyons¹,

Birch²,

Hillman

et al. 2010

FOC

View full text Add to dashboard Cite

Object Meige syndrome is characterized by blepharospasm, cervical dystonia, and facial oromandibular dystonia. The medical treatment of this condition is largely unsuccessful over time and is a major source of decreased quality of life in those patients suffering from this disease. Recent advances in the application of deep brain stimulation (DBS) surgery techniques for many disorders have prompted several recent reports of DBS for medically refractory cases of Meige syndrome. While the etiology for this disorder is unknown, it is considered by many investigators to be a form of idiopathic torsion dystonia. Pallidal stimulation is widely considered to be effective for dystonia. Methods The authors report the long-term results of bilateral globus pallidus internus (GPi) or subthalamic nucleus (STN) stimulation in 3 patients with Meige syndrome and 1 patient with Parkinson disease and associated craniofacial dystonia treated at their center. Results Initial 12-month and long-term follow-up Burke-Fahn-Marsden scores were substantially improved in all 4 patients compared with preoperative scores. Conclusions Bilateral GPi DBS may be an effective and safe treatment for medically refractory Meige syndrome. The results are comparable with those reported in the literature. Sustained and long-term improvement in symptoms does appear to be reproducible across reports. The authors' patient with Parkinson disease and associated craniofacial dystonia syndrome undergoing bilateral STN DBS noted immediate and sustained improvement in his symptoms. Further study is required, but these results, along with the other reports, suggest that bilateral GPi DBS is an effective treatment for medically refractory Meige syndrome.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Long-term follow-up of deep brain stimulation for Meige syndrome

Lyons¹,

Birch²,

Hillman

et al. 2010

FOC

View full text Add to dashboard Cite

show abstract

“…In such cases a treatment option can be stereotactic surgical ablation or deep brain stimulation (DBS) of the globus pallidus internus (GPi). A beneficial effect of GPi-DBS has been reported on the forms of MS associated with anterocollis and segmental axial dystonia [7] , with multifocal dystonia [8] , with segmental axial dystonia after ineffective bilateral thalamotomy [9] , with spasmodic torticollis [10,11] and with dystonic tremor [12] . There are only few reports on successful surgical treatment of isolated MS [13,14] .…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Unilateral Pallidotomy for Meige Syndrome Confirmed by Motion Analysis

Valálik

Jobbágy

Bognár

et al. 2011

Stereotact Funct Neurosurg

View full text Add to dashboard Cite

Background: We report the case of a 64-year-old woman with bilateral manifestation of Meige syndrome (MS) successfully treated with left-side unilateral ventroposterolateral pallidotomy. Methods: Symptoms were evaluated according to the Burke-Fahn-Marsden dystonia rating scale. Head tremor, blepharospasm and orofacial dyskinesia were measured with an infrared, video-based, computerized, real-time passive marker-based analyzer of motions (RTPAM). Results: The Burke-Fahn-Marsden score showed a 90.2% reduction (from 25.5 to 2.5) at 6 months, and an 88.2% long-lasting benefit (to 3.0) at the 3-year follow-up with good bilateral control of the blepharospasm and orofacial movements. The RTPAM showed a substantial regression of acceleration for all markers, and abolishment of the 4.8-Hz head tremor. The correlation between symmetrical markers, and between markers within the right and left sides, was significantly decreased. Conclusions: Pallidotomy with staged procedure is recommended for the treatment of MS in patients on whom deep brain stimulation could not be performed. In case of good bilateral benefits from the unilateral procedure, contralateral surgery is not needed. The RTPAM is a useful tool for the mapping of facial involuntary movements.

show abstract

Pallidal deep brain stimulation in patients with cranial–cervical dystonia (Meige syndrome)

et al. 2007

View full text Add to dashboard Cite

Idiopathic cranial-cervical dystonia (ICCD) is an adult-onset dystonia syndrome affecting orbicularis oculi, facial, oromandibular, and cervical musculature. ICCD is frequently difficult to treat medically. Deep brain stimulation (DBS) of the globus pallidus internus (GPi) is a highly effective treatment for idiopathic generalized dystonia, however less is known about the effect of GPi DBS on ICCD. In this article, we present the results from a pilot study assessing the effect of GPi DBS in a series of patients with ICCD. Six patients underwent bilateral stereotactic implantation of DBS leads into the sensorimotor GPi. Patients were evaluated with the Burke-Fahn-Marsden dystonia rating scale (BFMDRS) and Toronto western spamodic torticollis rating scale (TWSTRS) before surgery and 6 months postoperatively. At 6 months, patients showed a 72% mean improvement in the BFMDRS total movement score (P < 0.028, Wilcoxin signed rank test). The mean BFMDRS disability score showed a trend toward improvement (P < 0.06). The total TWSTRS score improved 54% (P < 0.043). Despite improvement in dystonia, mild worsening of motor function was reported in previously nondystonic body regions with stimulation in 4 patients. Although GPi DBS was effective in these patients, the influence of GPi DBS on nondystonic body regions deserves further investigation.

show abstract

Successful bilateral pallidal stimulation for Meige syndrome and spasmodic torticollis

Cited by 29 publications

References 2 publications

Long-term follow-up of deep brain stimulation for Meige syndrome

Long-term follow-up of deep brain stimulation for Meige syndrome

Effectiveness of Unilateral Pallidotomy for Meige Syndrome Confirmed by Motion Analysis

Pallidal deep brain stimulation in patients with cranial–cervical dystonia (Meige syndrome)

Contact Info

Product

Resources

About