Bilateral Pallidotomy for Dystonia with Glutaric Aciduria Type 1

  • 발행 : 2005.11.28

초록

Glutaric aciduria type 1 is an inborn error of lysine, hydroxylysine, and tryptophan metabolism caused by deficiency of glutaryl-coenzyme A dehydrogenase. The disease often appears in infancy with encephalopathy episode that results in acute basal ganglia and white matter degeneration. The majority of patients develop a dystonic-dyskinetic syndrome. This reports 6year-old boy who had been done previous gastrostomy due to swallowing difficulty underwent bilateral pallidotomy with intraoperative electromyography[EMG] monitoring for disabling dystonia. Intraoperative EMG was used to assess stimulation thresholds required for capsular responses and muscle tone. Surface EMG electrodes were placed on the face and cricopharyngeal muscles. Exact target were directly modified according to MRI-visualized anatomy. EMG response was consistently seen prior to visual observation of muscle activity. The surgery improved dystonic symptoms without swallowing difficulty.

키워드

참고문헌

  1. Ashby P, Strafella A, Dostrovsky JO, Lozano A, Lang AE : Immediate motor effects of stimulation through electrodes implanted in the human globus pallidus. Stereotact Funct Neurosurg 70 : 1-18, 1998
  2. Brandt NJ, Gregersen N, Christensen E, Gron IH, Rasmussen K : Treatment of glutaryl-CoA dehydrogenase deficiency (glutaric aciduria). Experience with diet, riboflavin, and GABA analogue. J Pediatr 94 : 669-673, 1979 https://doi.org/10.1016/S0022-3476(79)80048-7
  3. Burlina AP, Zara G, Hoffmann GF, Zschocke J, Burlina AB : Management of movement disorders in glutaryl-CoA dehydrogenase deficiency : anticholinergic drugs and botulinum toxin as additional therapeutic options. J Inherit Metab Dis 27 : 911-915, 2004 https://doi.org/10.1023/B:BOLI.0000045776.50573.52
  4. Eltahawy HA, Saint-Cyr J, Giladi N, Lang AE, Lozano AM : Primary dystonia is more responsive than secondary dystonia to pallidal interventions : outcome after pallidotomy or pallidal deep brain stimulation. Neurosurgery 54 : 613-619; discussion 619-621, 2004
  5. Landy HJ, Weiner WJ, Calancie B, Harris W, Shulman LM, Singer C, et al : Electromyography during stereotatic pallidotomy for parkinson's disease. Stereotact Funct Neurosurg 74 : 21-29, 2000 https://doi.org/10.1159/000056459
  6. Jankovic J, Lai EC, Ondo WG, Roberts-Warrior D, Olson SL, Krauss JK, et al : Effects of pallidotomy on gait and balance. Adv Neurol 87 : 271-281, 2001
  7. Lozano AM, Abosch A : Pallidal stimulation for dystonia. Adv Neurol 94 : 301-308, 2004
  8. Ondo WG, Desaloms JM, Jankovic J, Grossman RG : Pallidotomy for generalized dystonia. Mov Disord 13 : 693-698, 1998 https://doi.org/10.1002/mds.870130415
  9. Ondo WG, Jankovic J, Lai EC, Sankhla C, Khan M, Ben-Arie L, et al : Assessment of motor function after stereotactic pallidotomy. Neurology 50 : 266-270, 1998 https://doi.org/10.1212/WNL.50.1.266
  10. Prevett MC, Howard RS, Dalton RN, Olpin SE : Glutaric aciduria type 1 in adulthood. J Neurol Neurosurg Psychiatry 60 : 352-353, 1996 https://doi.org/10.1136/jnnp.60.3.352
  11. Rakocevic G, Lyons KE, Wilkinson SB, Overman JW, Pahwa R : Bilateral pallidotomy for severe dystonia in an 18-month-old child with glutaric aciduria. Stereotact Funct Neurosurg 82 : 80-83, 2004 https://doi.org/10.1159/000077405
  12. Strauss KA, Morton DH : Type I glutaric aciduria, part 2 : a model of acute striatal necrosis. Am J Med Genet C Semin Med Genet 121 : 53- 70, 2003
  13. Strauss KA, Puffenberger EG, Robinson DL, Morton DH : Type I glutaric aciduria, part 1 : natural history of 77 patients. Am J Med Genet C Semin Med Genet 121 : 38-52, 2003
  14. Voll R, Hoffmann GF, Lipinski CG, Trefz FK, Weisser J : Glutaric acidemia/glutaric aciduria I as differential chorea minor diagnosis. Klin Padiatr. 205 : 124-126, 1993 https://doi.org/10.1055/s-2007-1025211
  15. Yoshor D, Hamilton WJ, Ondo W, Jankovic J, Grossman RG : Comparison of thalamotomy and pallidotomy for the treatment of dystonia. Neurosurgery 48 : 818-824; discussion 824-816, 2001 https://doi.org/10.1097/00006123-200104000-00025