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  • Author or Editor: Kim J. Burchiel x
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Treatment of hemiballismus with stereotactic pallidotomy

Case report and review of the literature

Konstantin V. Slavin, Thomas K. Baumann and Kim J. Burchiel

Hemiballismus is a relatively rare movement disorder that is characterized by uncontrolled, random, large-amplitude movements of the limbs. It is usually caused by a vascular lesion that involves the contralateral subthalamic nucleus (STN) (also known as the nucleus hypothalamicus or corpus luysi) and its afferent and efferent pathways.

The authors present a case of medically intractable hemiballismus in a 70-year-old woman who was successfully treated with stereotactic posteroventral pallidotomy. In agreement with the data reported earlier by other groups, the microrecording performed during the pallidotomy showed a decreased rate of firing of the pallidal neurons, supporting the theory of impaired excitatory input from the STN to the internal part of the globus pallidus.

Stereotactic pallidotomy may be the procedure of choice in the treatment of medically intractable hemiballismus. Intraoperative microrecording significantly improves the precision of the stereotactic targeting and should be considered a standard part of the pallidotomy protocol.

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Konstantin V. Slavin, Randall R. Nixon, Gary M. Nesbit and Kim J. Burchiel

✓ The authors present the case of progressive thoracic myelopathy caused by the extensive ossification of the arachnoid membrane and associated intramedullary syrinx. Based on their findings and results of the literature search, they describe a pathological basis for this rare condition, discuss its incidence and symptomatology, and suggest a simple classification for various types of the arachnoid ossification. They also discuss the magnetic resonance imaging features of arachnoid ossification and associated spinal cord changes. The particular value of plain computerized tomography, which is highly sensitive in revealing intraspinal calcifications and ossifications, in the diagnostic evaluation of patients with a clinical picture of progressive myelopathy is emphasized.

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Konstantin V. Slavin, Randall R. Nixon, Gary M. Nesbit and Kim J. Burchiel

The authors present the case of a patient in whom progressive thoracic myelopathy was caused by the extensive ossification of the arachnoid membrane and associated intramedullary syrinx. Based on their findings and the results of a literature search, they describe a pathological basis of this rare condition, discuss its incidence and symptomatology, and suggest a simple classification of various types of the arachnoid ossification. They also discuss magnetic resonance imaging features of arachnoid ossification and associated spinal cord changes. Emphasis is placed on the particular value of plain computerized tomography, which is highly sensitive for detecting intraspinal calcifications and ossifications, in the diagnostic evaluation of patients whose clinical picture indicates progressive myelopathy.