Unilateral pallidotomy for hemidystonia

Abstract

Hemidystonia is a clinical presentation of many pathological conditions that can affect the basal ganglia. It is usually a refractory condition to current medical treatment. Recently, stereotactic procedures such as radiofrequency lesioning or deep brain stimulation provided hope for patients with dystonia; we are reporting the clinical outcome of a patient with hemidystonia treated with unilateral pallidotomy. A 15-year-old boy with no family history of movement disorders and normal perinatal history is presented. He started to have progressive dystonic contractions in the right hand and extended to involve both the upper and lower extremities in the right side over a period of 3 years. He was subjected to a left-sided posteroventral pallidotomy. Postoperatively, his hemidystonia improved over a period of a few weeks. The Unified Dystonia Rating Scale improved by 84%. He maintained the improvements for the 2-year postoperative follow-up period. No complications were encountered. Clinical presentation, surgical techniques, and surgical results are presented. In conclusion, hemidystonia may significantly respond to a contralateral posteroventral pallidotomy.