Choreo-ballistic movement after thalamotomy in a patient with Lewy body dementia.
J Clin Neurosci
; 66: 264-266, 2019 Aug.
Article
em En
| MEDLINE
| ID: mdl-31178303
ABSTRACT
Thalamotomy is an established treatment for medically refractory tremor. Major complications of thalamotomy include cognitive disturbance, paralysis, dysphagia, sensory loss, and speech disturbance. Hemiballism is a rare complication after thalamotomy. We herein present a 74-year-old female patient who developed choreo-ballistic movement after thalamotomy. She was diagnosed with Lewy body dementia at the age of 70â¯years and exhibited worsening bilateral hand tremor. Her tremor was severe and pharmacoresistant. Left thalamotomy was planned with the trajectory passing through the ventralis intermedius (VIM) nucleus to the posterior subthalamic area (PSA). The right VIM nucleus and PSA were both coagulated with one trajectory, resulting in the immediate amelioration of right hand tremor. However, four days after surgery, choreo-ballistic movement appeared in the right leg and persisted for six months. Furthermore, tremor recurred after one month. Postoperative MRI showed a small coagulated lesion in the subthalamic nucleus. Although choreo-ballistic movement is a rare complication, it needs to be considered, particularly in patients in which the inferior border of the VIM nucleus is targeted.
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Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
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Psicocirurgia
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Tálamo
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Coreia
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Doença por Corpos de Lewy
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article