Meige syndrome relieved by bilateral pallidal stimulation with cycling mode: case report.

Abstract:

BACKGROUND AND IMPORTANCE:Deep brain stimulation (DBS) of the bilateral globus pallidus internus (GPi) has been used effectively to treat dystonia. We report a patient with severe Meige syndrome who received bilateral GPi DBS with good improvement in symptoms during the first 24-month stimulation therapy. To decrease energy consumption and to prolong battery life, the stimulation parameters of the replaced programmable pulse generator were adjusted to the cyclic mode and the stimulator was turned off during nighttime sleep. The patient achieved similar good treatment effect with extended battery life in the following years. CLINICAL PRESENTATION:A 66-year-old woman with a 3-year history of severe cranial-cervical dystonia received stereotaxic surgery for bilateral GPi DBS therapy. The Burke-Fahn-Marsden dystonia score improved from 32 to 7.5. The effect lasted up to 24 months after therapy when the battery ran out of life. After careful evaluation, we adjusted the stimulation parameters of the second implantable pulse generator to the cyclic stimulation mode and programmed the stimulator to turn off automatically during nighttime sleep. The patient showed persistent good effect 36 months after starting use of the second implantable pulse generator. CONCLUSION:To treat dystonic symptoms effectively, stimulation parameters with higher energy consumption are usually required. For reducing the discomfort of repeated battery replacement within a short time and decreasing energy consumption in implantable pulse generator, cyclic mode stimulation could be considered in dystonic patients receiving bilateral GPi DBS.

journal_name

Neurosurgery

journal_title

Neurosurgery

authors

Tai CH,Wu RM,Liu HM,Tsai CW,Tseng SH

doi

10.1227/NEU.0b013e31822a9ad2

subject

Has Abstract

pub_date

2011-12-01 00:00:00

pages

E1333-7

issue

6

eissn

0148-396X

issn

1524-4040

journal_volume

69

pub_type

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