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Objective:To investigate the effect of bilateral globus pallidus internus deep brain stimulation (GPi-DBS) on motor performance, quality of life, sleep quality, neuropsychological status, and mood in patients with Meige syndrome.Methods:The clinical data of 17 patients with Meige syndrome accepted bilateral GPi-DBS in Department of Neurosurgery, People's Hospital of Peking University from May 2019 to March 2021 were retrospectively analyzed. Established and validated rating scales were used to assess the motor performance, quality of life, sleep quality, neuropsychological status, and mood at baseline, and 1 and 2 years after GPi-DBS.Results:Burke-Fahn-Marsden dystonia rating scale (BFMDRS) motor total scores decreased from 14.4±6.2 at baseline to 4.3±2.2 and 3.5±1.9 at 1 and 2 years after GPi-DBS, with significant differences ( P<0.05). BFMDRS disability total scores decreased from 6.2±4.0 at baseline to 2.8±2.0 and 2.2±1.5 at 1 and 2 years after GPi-DBS, with significant differences ( P<0.05). In 36-item Short-Form Health Survey (SF-36), the scores of physical function, role-physical, general health sub-items at 1 and 2 years after GPi-DBS were significantly higher than those at baseline ( P<0.05). No significant differences were noted in scores of sleep quality, neuropsychological function, or mood scales at 1 and 2 years after GPi-DBS compared with those at baseline ( P>0.05). Conclusion:Bilateral GPi-DBS is effective and safe in Meige syndrome, which can improve dystonic symptom and quality of life without adverse effects on sleep quality, neuropsychological function, or emotional status.
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Objective:To explore the pathogenesis of glossopharyngeal neuralgia (GPN) in central nervous system from perspective of brain morphology.Methods:A prospective study was performed. Twenty-seven patients with right primary GPN admitted to Department of Neurosurgery, People's Hospital of Peking University from April 2019 to June 2023 and 27 healthy subjects (controls) matched with age, gender, dominant hand, and education level during the same period were recruited. These patients were divided into GPN with neurovascular compression group ( n=18) and GPN without neurovascular compression ( n=9) based on intraoperative presence of neurovascular compression. SPM8 software based on Matlab R2017b programming platform and VBM8 toolbox were used to process the whole-brain high-resolution 3D-T1 brain structural image data of the participants and analyze the differences in the gray matter volume of each brain region between the 2 groups. Pearson correlation was applied to analyze the correlations of gray matter volumes in brain regions enjoying significant difference with baseline data and pain characteristics of these GPN patients. Results:Compared with controls, patients with GPN had significantly reduced gray matter volumes in the left anterior cingulate gyrus, middle temporal gyrus, transverse temporal gyrus, precentral gyrus, postcentral gyrus, right insula, thalamus, inferior parietal lobule, precentral gyrus, middle temporal gyrus, and inferior temporal gyrus ( P<0.05, FDR corrected). Compared with GPN patients with neurovascular compression, GPN patients without neurovascular compression had significantly reduced gray matter volume in the bilateral anterior cingulate gyrus ( P<0.05, FDR corrected). Changes of gray matter volume in the right insula were negatively correlated with disease duration of GPN patients ( r=-0.521, P=0.005). Conclusion:GPN patients have extensive gray matter atrophy in the brain, which may play an essential role in GPN development and maintenance.
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Meige syndrome is a rare segmental craniocervical dystonia, mainly characterized by blepharospasm and involuntary contraction of jaw and neck muscles, which will seriously decrease the patient's quality of life. The etiology and pathogenesis of the disease remain unclear, despite of some progress having been made in the relevant studies. Current treatments include drug therapy, botulinum toxin A injection and surgical treatment. In this article, the pathogenesis, clinical manifestations and treatment of Meige syndrome will be briefly reviewed.
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Objective To compare the sedative efficacy and untoward effect of dexmedetomidine and midazolam in drunken patients after general anesthesia.Methods Thirty-eight drunken patients having underwent mechanical ventilation after general anesthesia were enrolled.The patients were divided into dexmedetomidine group and midazolam group with 19 cases each according to random digital table method.The sedation onset time,dysphoria,percentage of with good sleep quality,duration of mechanical ventilation,ICU length of staying and untoward effect were compared.Results The sedation onset time and duration of mechanical ventilation in dexmedetomidine group were significantly shorter than those in midazolam group:(45.6 ±8.9) s vs.(112.5 ±20.3) s and (9.4 ±2.1) h vs.(18.6 ±5.1) h,the patients of dysphoria in dexmedetomidine group was significantly less than that in midazolam group:6 cases vs.14 cases,the patients of good sleep quality in dexmedetomidine group was significantly more than that in midazolam group:12 cases vs.4 cases,and there were statistical differences (P＜ 0.05).There was no statistical difference in ICU length of staying between 2 groups (P ＞ 0.05).The patients of bradyarrhythmia in dexmedetomidine group was significantly more than that in midazolam group:9 cases vs.2 cases,but the patients of respiratory depression in dexmedetomidine group was significantly less than that in midazolam group:4 cases vs.12 cases,and there were statistical differences (P ＜ 0.05).There were no statistical differences in delirium and hypopiesis between 2 groups (P ＞ 0.05).Conclusion Compared with midazolam,dexmedetomidine is highly recommended to be used for the sedation of drunken patients after general anesthesia,but the incidence of circulatory adverse reactions should be paid attention to.
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Objective To analyze the effect of dexmedetomidine hydrochloride injection on patients with craniocerebral disease who has no artificial airway in the process of bronchoalveolar lavage treatment.Methods Forty-six patients (age 17-28,average age 56.6±9.2,26 men and 20 women) with craniocerebral disease who has no artificial airway were selected,and were treated by bronchoalveolar lavage for lung infection.The patients were randomly divided into two groups,control and test group.The control group (n=23) received midazolam for sedative and the test group (n=23) received dexmedetomidine hydrochloride for sedative while they were in the process of bronchoalveolar lavage treatment.Heart rate,mean arterial pressure and blood oxygen saturation of fingers collected from patients before and during the process of bronchoalveolar lavage were compared.Results In the process of bronchoalveolar lavage treatment,the minimum blood oxygen saturation of finger artery from the control group was lower than that from the test group,the fastest heart rate from the control group was greater than that from the test group,and the lowest mean arterial pressure from the control group was lower than that from the test group (P＜0.05).In two groups,heart rate in the process of bronchoalveolar lavage treatment was faster than that from before the treatment,while both mean arterial pressure and blood oxygen saturation of finger artery were decreased (P＜0.05).Conclusions Continuous intravenous pumping of dexmedetomidine hydrochloride on patients with craniocerebral disease who has no artificial airway during the process of bronchoalveolar lavage treatment is effective and safe,and it has less inhibitory effect on respiratory function and blood pressure.