Globus pallidus internus activity during simultaneous bilateral microelectrode recordings in status dystonicus
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CASE REPORT - FUNCTIONAL NEUROSURGERY - MOVEMENT DISORDERS
Globus pallidus internus activity during simultaneous bilateral microelectrode recordings in status dystonicus Vincenzo Levi 1 G. Zorzi 4
&
A. Franzini 2 & S. Rinaldo 3 & S. Coelli 1 & A. M. Bianchi 1 & A. Franzini 2 & N. Nardocci 4 & R. Eleopra 3 &
Received: 5 July 2020 / Accepted: 9 October 2020 # Springer-Verlag GmbH Austria, part of Springer Nature 2020
Abstract Limited data are available regarding the electrophysiology of status dystonicus (SD). We report simultaneous microelectrode recordings (MERs) from the globus pallidus internus (GPi) of a patient with SD who was treated with bilateral deep brain stimulation (DBS). Mean neuronal discharge rate was of 30.1 ± 10.9 Hz and 38.5 Hz ± 11.1 Hz for the right and left GPi, respectively. On the right side, neuronal electrical activity was completely abolished at the target point, whereas the mean burst index values showed a predominance of bursting and irregular activity along trajectories on both sides. Our data are in line with previous findings of pallidal irregular hypoactivity as a potential electrophysiological marker of dystonia and thus SD, but further electrophysiological studies are needed to confirm our results. Keywords Deepbrainstimulation (DBS) . Statusdystonicus . Microelectroderecording(MER) . Intraoperativeneurophysiology . Movement disorder surgery
Introduction Status dystonicus (SD) is a rare type of movement disorder characterized by severe episodes of generalized dystonia, focal dystonia, or other hyperkinetic movements. This condition necessitates urgent hospital admission due to the risk of direct life-threatening complications [9]. Although stereotactic lesioning and electrode implantation within the globus pallidus internus (GPi) have both been This article is part of the Topical Collection on Functional Neurosurgery - Movement disorders * Vincenzo Levi [email protected] 1
Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci, 32, 20133 Milan, Italy
2
Neurosurgery Department, Functional Neurosurgery Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
3
Neurology Unit 1, Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
4
Pediatric Neuroscience Department, Child Neuropsychiatry Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
reported as effective means for halting medically intractable SD, mortality still occurs in about 10% of cases [1, 8, 13]. To date, few studies have investigated intraoperative electrophysiological recordings during SD. An in-depth knowledge of the electrophysiological underpinnings of SD may help in the development of effective treatment strategies and in a better understanding of SD pathophysiological basis. Here, we report on neurophysiological data recorded from a patient who developed SD and treated with bilateral GPi deep brain stimulation (DBS).
Methods Clinical history This 15-year-old girl
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