脑深部电刺激术治疗扭转痉挛

Deep brain stimulation in the treatment of torsion dystonia

目的探讨脑深部电刺激术（ deep brain stimulation, DBS）治疗扭转痉挛（torsion dystonia，TD）的疗效。方法3例TD患者，其中2例行双侧苍白球内侧部一脑深部电刺激术（GPi-DBS），1例行双侧丘脑底核一脑深部电刺激术（STN-DBS）。3例患者术前及术后3、6、12个月分别采用Burke-Fahn-Marsden肌张力障碍运动评分量表（Burke-Fahn-Marsden Dystonia Rating Scale，BFMDRS）进行评分。结果所有患者开机后症状立即都有不同程度的改善，随访3、6、12个月，2例行GPi-DBS的患者改善率为6l％一98％；1例行STN-DBS的患者改善率为40％～60％。所有患者未出现手术相关并发症及永久性不良反应。结论DBS是一种安全、有效治疗TD的方法，但长期疗效尚待进一步随访。

Objective To assess clinical efficacy of deep brain stimulation in the treatment of three cases of torsion dystonia （TD）. Methods Two TD patients underwent bilateral globus pallidus intemus deep brain stimulation （GPi-DBS）. Another patient underwent bilateral subthalamic nucleus deep brain stimulation（STN-DBS）. Preoperative and postoperative （ 3 months, 6 months , 12 months） Burke-Fahn- Marsden dystonia rating scale （BFMDRS） were performed on each patient. Results All patients experienced immediate improvement before starting stimulation. Three patients were followed-up over 12 months. The two patients with GPi-DBS showed improvement from 61% to 98%. The patient with STN-DBS showed improvement from 40% to 60%. All patients had no surgery-related complications and permanent side effects. Conclusions Stereotactic bilateral GPi-DBS or STN-DBS may be an effective and safe for the treatment of TD. However, the long-term effect should be followed up.