Article

Status dystonicus is a rare and potentially fatal condition of continuous
and generalized muscle contraction that can complicate dystonia. As status
dystonicus is usually refractory to traditional pharmacological therapy,
alternative and invasive strategies have been developed, but so far there are no
guidelines on status dystonicus management. Pallidotomy has shown good results in
status dystonicus treatment. METHOD: We report indications, surgical strategy,
and outcome of bilateral pallidotomy in four pediatric patients (four males; mean
age at surgery 11y 5mo) with secondary dystonia, who developed refractory status
dystonicus. Pallidotomy was performed in the area corresponding to the mid
portion of the globus pallidus internus. RESULTS: This procedure allowed patients
to recover the pre-status dystonicus condition, controlling dystonic postures and
movements of trunk and limbs. Moreover oromandibular dystonia, which is resistant
to conservative approaches and deep brain stimulation, was significantly reduced.
No postoperative complications were registered. INTERPRETATION: Our study
suggests pallidotomy as a feasible treatment in patients with secondary dystonia
complicated by status dystonicus.
CI - (c) 2014 Mac Keith Press.

Langue : ANGLAIS