, dyslexia, and Ehlers-Danlos syndrome. 2 , 7 , 8 , 11 , 18 Here, we describe 2 pediatric patients with deep heterotopias contiguous with the basal ganglia structures. These heterotopias appear to have manifested as movement disorders. The patient in Case 1 presented with a left-sided myoclonus and choreiform movements associated with a right caudate heterotopia. The patient in Case 2 presented with progressive dystonia and a ballistic movement disorder associated with insular heterotopia. In both cases, the movement disorder responded favorably to resection of the
Report of 2 cases
Jeffrey P. Mullin, Jamie J. Van Gompel, Kendall H. Lee, Fredric B. Meyer and Matt Stead
Report of 4 cases
Paritosh Pandey, Teresa Bell-Stephens and Gary K. Steinberg
TIAs or ischemic strokes in children and hemorrhage in adults. Atypical presentations include headaches, seizures, cognitive impairment, and dementia. 4 , 12 Movement disorders as presenting features in patients with moyamoya disease are extremely rare. Symptoms of such disorders probably arise from ischemia or changes in the excitatory and inhibitory circuits interconnecting the basal ganglia and cerebral cortex. In a majority of the prior case reports, ischemia involved the frontal subcortical matter, and basal ganglia ischemia causing movement disorders was
Dennis E. Bullard and Blaine S. Nashold Jr.
I n 1909, Horsley 11 reported relief of a hemiathetosis by resection of the precentral gyrus. Since that time, numerous approaches have been used for surgical relief of involuntary movement. Beginning in 1947 with the first stereotaxic operation for relief of an involuntary movement disease by Spiegel, et al. , 20 the majority of recent surgical approaches have been stereotaxic. Currently, the most widely utilized approach is a thermal lesion in the ventrolateral (VL) thalamus. This appears to be effective for the majority of movement disorders (MD's) 15
Joachim K. Krauss, Jan J. Borremans, Thomas Pohle and Nelson Godoy
T he occurrence of postoperative morbidity after neurosurgical procedures has gained widespread attention within the past few years. 1 In particular, in developing strategies for avoidance of surgical side effects, it is important to recognize and understand underlying mechanisms. 14 Such knowledge has helped to reduce surgical morbidity significantly over the years. 16 Although motor deficits, sensory dysfunctions, and cognitive and behavioral sequelae are well recognized complications of neurosurgical procedures, the occurrence of movement disorders, in
Hugues Duffau, Dominique Denvil and Laurent Capelle
I n addition to the many observations reported for neurodegenerative diseases, 1, 13, 27, 34, 50, 53, 79 movement disorders such as hemichorea, 18, 35, 38, 45, 73, 84 hemiballismus, 17, 32, 58, 75 dystonia, 30, 56, 74 athetosis, 20 or tonic spasms 61 were also extensively described in stroke involving the striatum alone 32, 35, 38, 58, 76, 84 or the striatum in association with other basal ganglia: GP, thalamus, and STN. 17, 18, 51, 57, 62, 75 These abnormal movements rarely occur, however, in comparison with the high rate of stroke involving the
Chihiro Ohye, Tohru Shibazaki, Jie Zhang and Yoshitaka Andou
primary procedure and 29 cases in which it was a secondary procedure, applied to a symmetrical target, as defined previously. 12 TABLE 1 Results of gamma thalamotomy Characteristic No. of Cases movement disorders 53 PD tremor type 32 rigid type 3 essential tremor 11 intentional tremor 5 posttraumatic tremor 1 dystonia 1 Preoperative Procedures The patients were usually hospitalized for 3 days. The 1st day is for necessary general examinations such as blood
Mark Hornyak, Richard L. Rovit, Arlene Stolper Simon and William T. Couldwell
Irving S. Cooper was a pioneer in the field of functional neurosurgery. During his very productive and controversial career, he proposed the surgical treatment of Parkinson disease (PD) by ligating the anterior choroidal artery to control tremor and rigidity. Subsequently, he developed seminal techniques for chemopallidectomy and cryothalamectomy for PD. He also attempted to use electrical stimulation of the cerebellum or the thalamus to treat spasticity. Cooper continued his work on brain stimulation until his death in 1985. He made video recordings of nearly all of his patients during his tenure (1977–1985) at New York Medical College.
Cooper's clinical video recordings were reviewed, and selected footage was compiled into a video history of Cooper's surgical management of various movement disorders. Included are pre-, post-, and some intraoperative recordings that Cooper made to document his treatment of patients with PD, tremor, Wilson disease, cerebral palsy, chorea, dystonia musculorum deformans, and some rarer entities.
Report of two cases
Todd P. Thompson, Douglas Kondziolka and A. Leland Albright
S urgery for movement disorders is most commonly performed in patients with dyskinesia and tremor associated with Parkinson's disease or in those with essential tremor. Increasingly, cerebral stimulation is used to achieve similar results, while avoiding the creation of a destructive lesion. Patients with spastic and dystonic cerebral palsy often benefit from dorsal rhizotomies and implanted intrathecal baclofen pumps; however, these interventions do not improve chorea or athetosis. The goal of each of these procedures is to remove the disabling symptoms of the
Chao-Hung Kuo, Gabrielle A. White-Dzuro and Andrew L. Ko
D eep brain stimulation (DBS) is a safe and effective therapy for movement disorders, such as Parkinson’s disease (PD), essential tremor (ET), and dystonia. 2 , 7 , 15 The devices have been in clinical use for decades, providing invariant stimulation at a fixed spatial distribution (electrode configuration), amplitude, frequency, and pulse width. This “open-loop” therapy relies on the determination of effective stimulation parameters by a clinician. As our understanding of the mechanisms underlying this therapy and movement disorders in general expands, the
Tohru Terao, Hiroshi Takahashi, Fusako Yokochi, Makoto Taniguchi, Ryouichi Okiyama and Ikuma Hamada
S tereotactic surgery for movement disorders has recently undergone a resurgence of interest. 2, 8, 12, 28, 36, 43, 44 At many centers MER is now used to enhance the precision of stereotactic procedures. 23 Whether the beneficial information received by recording microelectrode passes outweighs the risk of tissue damage, however, remains controversial. 19 Of particular concern is the induction of intracranial hemorrhage by microelectrode penetration. 26 Hematomas occasionally induce clinical symptoms such as changes in consciousness, hemiparesis, or visual