Thalamus Stimulation for Myoclonus Dystonia Syndrome: Five Cases and Long-Term Follow-up

World Neurosurg. 2019 Feb:122:e933-e939. doi: 10.1016/j.wneu.2018.10.177. Epub 2018 Nov 10.

Abstract

Background: Myoclonic dystonia syndrome (MDS) is a rare inherited movement disorder characterized by the coexistence of myoclonic jerks and dystonia. Deep brain stimulation (DBS) is a promising treatment for patients with MDS that targets the globus pallidus internus or ventral intermediate nucleus (Vim) of the thalamus. However, there are few studies regarding the long-term effects of Vim DBS in patients with MDS and even fewer in those without gene mutations.

Methods: Two positive and three negative SGCE mutation patients presenting with predominant myoclonus underwent Vim DBS. The Unified Myoclonus Rating Scale and the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) were assessed pre- and postoperation.

Results: Over an average follow-up period of 50 months, the myoclonus improvement rate was 92.7%. The average improvement in the BFMDRS motor score was 71.4% and the average improvement in the BFMDRS disabling score was 75.8%.

Conclusions: This study suggests that Vim DBS can be a safe and effective treatment option for patients with MDS. Vim DBS alone may be preferable for patients with myoclonus-dominated MDS regardless of the identification of an SGCE mutation. Additional globus pallidus internus DBS may be used for progressive dystonia after Vim DBS.

Keywords: Deep brain stimulation; Myoclonic dystonia syndrome; Ventral intermediate nucleus.

MeSH terms

  • Adolescent
  • Adult
  • Deep Brain Stimulation / methods*
  • Dystonic Disorders / diagnostic imaging*
  • Dystonic Disorders / therapy*
  • Electrodes, Implanted
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Thalamus / diagnostic imaging*
  • Treatment Outcome
  • Young Adult

Supplementary concepts

  • Myoclonic dystonia