Ümit EROĞLU, Ali SAVAŞ, Muhittin Cenk AKBOSTANCI

Distoni Tedavisinde Stereotaktik Radyofrekans Derin Beyin Lezyonları

Amaç: Hareket bozuklukları kas kasılmalarının hızı, niteliği ve fizibilitesini etkileyen nörolojik rahatsızlıklardır. Bu çalışmanın amacı, talamotomi ve kampotomi kombinasyonunun bir grup hasta üzerinde cerrahi sonuçlarının değerlendirilmesini ve daha önce bilinen uygulamalarla karşılaştırılmasıdır. Gereç ve Yöntem: Bu çalışmaya 1997 ve 2003 yılları arasında talamotomi-kampotomi yapılan 25 distoni hastası dahil edilmiştir. Tüm hastalar aynı nörolog tarafından UPDRS ve Fahn-Burke-Marsden distoni skalalarına göre cerrahi öncesi ve sonrası dönemlerde değerlendirilmiştir. Bulgular: Çalışmaya 18 erkek (%72) ve yedi kadın (%28) hasta (14-65 yaş, ortalama 26,6 yıl) dahil edilmiş olup genel distoni (n=11, %44), hemidistoni (n=8, %34) ve distonik tremor (n=6, %24) tanıları ile takip edilmişlerdir. Sekonder distoni tanısıyla izlenen 20 hastanın 18’i serebral palsi, bir multiple skleroz ve bir inme sonrası distoni olarak kabul edilmiştir. Sonuç: Gpi DBS primer distoni hastalarında daha uygun bir uygulama olarak görülmektedir. Talamotomi-Kampotomi kombinasyonu sekonder distoni tanılı hastalarda başarılı bir metod olarak kabul edilebilir ve tedavi alternatifleri arasında değerlendirilmesi gereken bir seçenek olarak bulunmalıdır.

Stereotactic Radiofrequency Deep Brain Lesioning in Treatment of Dystonia

Objectives: Movement disorders are neurologic diseases that affect speed, quality and feasibility of muscle contractions. Aim of this study is, toassess the surgical outcomes of radiofrequency lesioning through deep brain stimulation (DBS) in a group of patients and comparing these resultsto the formerly known conventional procedures.Materials and Methods: This study involved 25 dystonia patients in whom radiofrequency lesioning through DBS procedures were performedbetween 1997 and 2003. All of the patients were examined by the same neurologist and examined due to UPDRS, Fahn-Burke-Marsden dystoniarating scales pre and post operatively.Results: Eighteen male (72%) and seven female (28%) patients (range=14-65 years, mean=26.6 years) with diagnosis of general dystonia (n=11,44%),hemidystonia (n=8, 34%) and dystonic tremor (n=6, 24%) enrolled in the study. Twenty patients with secondary dystonia involved 18 cerebralpalsies, one multiple sclerosis and one poststroke dystonia cases.Conclusion: Gpi DBS seems to be a more considerable approach for primary dystonia patients. Radiofrequency deep brain lesioning can be definedas a successful method for secondary dystonia treatment and must be implicated among treatment options.

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