Acute Hyperkinetic Syndromes Treated with Stereotactic Neurosurgery Intervention – Three Case Reports

Czech version

Authors: A. Fečíková ¹; R. Jech ¹; J. Roth ¹; M. Bareš ²; O. Černá ³; Z. Libá ⁴; D. Kemlink ¹; J. Fiksa ¹; A. Křepelová ⁵; D. Urgošík ^1,6
Authors‘ workplace: Neurologická klinika a Centrum klinických neurověd, 1. LF UK a VFN v Praze ¹; 1. neurologická klinika LF MU a FN u sv. Anny v Brně ²; Klinika dětského a dorostového lékařství 1. LF UK a VFN v Praze ³; Klinika dětské neurologie 2. LF UK a FN v Motole, Praha ⁴; Ústav biologie a lékařské genetiky, 2. LF UK a FN v Motole, Praha ⁵; Stereotaktická a radiační neurochirurgie, Nemocnice Na Homolce, Praha ⁶
Published in: Cesk Slov Neurol N 2015; 78/111(5): 591-596
Category: Case Report
doi: https://doi.org/10.14735/amcsnn2015591

Overview

Dyskinetic movement disorders may rarely progress to an acute life-threatening condition requiring admission to an intensive care unit, deep sedation and mechanical ventilation. Stereotactic neurosurgery (pallidotomy or deep brain stimulation) should be considered in all patients who did not respond to pharmacological treatment. We report three patients who underwent stereotactic neurosurgery due to acute dyskinetic syndrome. Two boys (12 and 6 years) with generalized hereditary dystonia (DYT-6 and DYT-1) developed status dystonicus and were treated with deep brain stimulation of the globus pallidus interna. The third patient was a 21-years-old woman with Huntington’s disease who underwent a pallidotomy due to acute worsening of generalized chorea with ballistic movements. Despite the initial critical state of all three patients, their abnormal movements significantly subsided within six weeks after the neurosurgery. The stereotactic neurosurgical procedure should be considered as the method of choice in patients with acute life-threatening hyperkinetic movement disorders that failed to improve with pharmacological treatment.

Key words:
deep brain stimulation – globus pallidus – pallidotomy – hyperkinetic syndromes – status dystonicus – chorea – ballism

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

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