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Yu-Cheng Chou, Chau-Chin Lee, Pao-Sheng Yen, Jui-Feng Lin, Chain-Fa Su, Shinn-Zong Lin, and Wu-Fu Chen

✓ The authors report a very rare case of high cervical ossification of the ligamentum flavum (OLF) in a 40-year-old woman who developed an intractable cough after a traffic accident. The patient's symptoms subsided immediately after decompressive laminectomy and removal of the lesion. To the authors' knowledge, this is the first reported case of high cervical OLF in a patient who presented with a cough. The pathophysiological mechanism underlying the cough was determined to be symptomatic of high cervical spine OLF.

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Zong-Yu Yu, Ming-Hsuan Chung, Peng-Wei Wang, Yi-Chieh Wu, Hsiang-Chih Liao, and Dueng-Yuan Hueng

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Sheng-Huang Lin, Tsung-Ying Chen, Shinn-Zong Lin, Ming-Hwang Shyr, Yu-Cheng Chou, Wanhua Annie Hsieh, Sheng-Tzung Tsai, and Shin-Yuan Chen

Object

The authors of this preliminary study investigated the outcome and feasibility of intraoperative microelectrode recording (MER) in patients with Parkinson disease (PD) undergoing deep brain stimulation of the subthalamic nucleus (STN) after anesthetic inhalation.

Methods

The authors conducted a retrospective analysis of 10 patients with PD who received a desflurane anesthetic during bilateral STN electrode implantation. The MERs were obtained as an intraoperative guide for final electrode implantation and the data were analyzed offline. The functional target coordinates of the electrodes were compared preoperatively with estimated target coordinates.

Results

Outcomes were evaluated using the Unified Parkinson's Disease Rating Scale 6 months after surgery. The mean improvement in total and motor Unified Parkinson's Disease Rating Scale scores was 54.27 ± 17.96% and 48.85 ± 16.97%, respectively. The mean STN neuronal firing rate was 29.7 ± 14.6 Hz. Typical neuronal firing patterns of the STN and substantia pars nigra reticulata were observed in each patient during surgery. Comparing the functional target coordinates, the z axis coordinates were noted to be significantly different between the pre- and postoperative coordinates.

Conclusions

The authors found that MER can be adequately performed while the patient receives a desflurane anesthetic, and the results can serve as a guide for STN electrode implantation. This may be a good alternative surgical method in patients with PD who are unable to tolerate deep brain stimulation surgery with local anesthesia.

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Zong-Yu Yu, Ming-Hsuan Chung, Peng-Wei Wang, Yi-Chieh Wu, Hsiang-Chih Liao, and Dueng-Yuan Hueng