Pallidothalamic Tractotomy after Pallidotomy for Medication‐Refractory Dystonia: Preliminary Short‐Term Results from a Case Series of Five Patients
Year: 2025
Type: article
Study design: Case Report
Abstract: BACKGROUND: There is limited data regarding the role of pallidothalamic tract (PTT) lesioning after failure of pallidotomy. OBJECTIVES: To report the role of unilateral PTT lesioning in refractory generalized dystonia following bilateral pallidotomy and hemi-dystonia following unilateral pallidotomy. METHODS: A single-center retrospective case series. RESULTS: Five patients underwent unilateral PTT lesioning after the failure of pallidotomy to control dystonia, including status dystonicus in one case. The interval between pallidotomy and PTT lesioning ranged from 2 to 90 months. Pre-PTT surgery, BFMDRS-M scores ranged from 20 to 87, and BFMDRS-D scores ranged from 8 to 23. Immediately post-PTT surgery, improvement was observed in four patients, with objective improvements ranging between 57.5 and 93.3% in the BFMDRS-M score. Two patients developed adverse effects: one experienced a mild worsening of post-pallidotomy dysarthria, and another developed impaired hand dexterity. CONCLUSIONS: Our initial experience suggests that unilateral PTT lesioning holds promise as an option for lesional surgery following pallidotomy, in refractory dystonia.
DOI: 10.1002/mdc3.70306
Authors: Divyani Garg, Animesh Das, Arnab Adhya, Divya M. Radhakrishnan, Roopa Rajan, Arunmozhimaran Elavarasi, Ashem Thoibisana, Ajay Garg, Achal Kumar Srivastava, Manmohan Singh, P. Sarat Chandra, Kanwaljeet Garg
Institution: All India Institute of Medical Sciences
Language: English
Subfield: Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4413569756