| Effects of Stereotactic Ventralis Oralis Thalamotomy on Writer's Cramp |
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Gun Sang Lee, Ki Myung Lee, Woo Jae Kim, Ho Sang Kim, Jeong Ho Kim, Yun-Suk Kim |
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Department of Neurosurgery, Maryknoll General Hospital, Busan, Korea |
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| Abstract |
Objective
To determine the efficacy of stereotactic ventralis oralis (Vo) thalamotomy in the management of medically refractory
writer’s cramp in the right hand.
Materials and Methods: Ten patients underwent left Vo thalamotomy using macroelectrode stimulation and were followed for
16.9±15.1 months (range 1–50). The mean duration of the writer’s cramp was 35.2±18.0 months, and the mean age at the time
of surgery was 36.0±12.0 years. The stereotactic target was selected via indirect targeting at the junction of the anterior and
posterior Vo nuclei. The patients were evaluated using the handwriting disability subscores of the Burke-Fahn-Marsden dystonia
rating scale.
Results
The preoperative handwriting score was 3 (illegible writing) in all the patients. Postoperatively, the handwriting scores
were rated as 0 (normal) in five (50.0%) patients, 1 (slight difficulty) in four (40%) patients, and 3 (illegible) as a relapsed case in
one (10%) patient. This showed significant improvement at the last follow-up after surgery (p<0.05). Transient mild dysarthria
occurred in one patient. No patients had permanent major complications.
Conclusion
Our results show that Vo thalamotomy is an effective method for achieving significant improvements in most patients with intractable writer’s cramp. |
| Key Words:
Focal dystonia, Writer's cramp, Thalamotomy. |
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