立体定向丘脑腹中间核毁损术治疗书写痉挛的疗效评估

目的探讨丘脑腹中间（Vim）核毁损术治疗书写痉挛的有效性和安全性。方法采用微电极引导下左侧丘脑Vim核毁损治疗书写痉挛（WC）患者47例,其中男32例,女15例;年龄15-64岁,平均（28.9±10.7）岁;病程2-21年。在术前和术后,采用书写痉挛评分量表（the writer＇s cramp rating scale,WCRS）对患者进行评分。结果全部患者毁损手术当时症状就明显改善,肘部、腕部和手指痉挛明显缓解,写字的流利程度和速度明显提升。其中2例患者（4.2%）出现一过性的右手指尖麻木;另有3例患者（6.4%）出现一过性言语不流利;上述并发症在3个月内完全恢复,没有永久性并发症发生。...

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Bibliographic Details
Published in临床神经外科杂志 Vol. 13; no. 6; pp. 412 - 414
Main Author 李建宇 张宇清 庄平 李勇杰
Format Journal Article
LanguageChinese
Published 10053 北京,首都医科大学宣武医院功能神经外科,北京市功能神经外科研究所 2016
Subjects
丘脑腹中间核
书写痉挛
脑深部核团毁损术
脑深部核团毁损术
书写痉挛
writer's cramp
丘脑腹中间核
ventralis intermedius nucleus of thalamotomy
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ISSN1672-7770
DOI10.3969/j.issn.1672-7770.2016.06.004

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Summary:目的探讨丘脑腹中间（Vim）核毁损术治疗书写痉挛的有效性和安全性。方法采用微电极引导下左侧丘脑Vim核毁损治疗书写痉挛（WC）患者47例,其中男32例,女15例;年龄15-64岁,平均（28.9±10.7）岁;病程2-21年。在术前和术后,采用书写痉挛评分量表（the writer＇s cramp rating scale,WCRS）对患者进行评分。结果全部患者毁损手术当时症状就明显改善,肘部、腕部和手指痉挛明显缓解,写字的流利程度和速度明显提升。其中2例患者（4.2%）出现一过性的右手指尖麻木;另有3例患者（6.4%）出现一过性言语不流利;上述并发症在3个月内完全恢复,没有永久性并发症发生。术后对患者进行电话随访,随访时间6-36个月,平均23个月;结果显示,患者的症状改善稳定;其中有3例患者失随访。另外,有1例患者因症状反复,再次行丘脑Vim核毁损术,术后症状改善明显。结论丘脑Vim核毁损术治疗书写痉挛是一种有效、安全的手术方式。
Bibliography:LI Jian-yu, ZHANG Yu-qing, ZHUANG Ping, et al（ Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beifing 100053, China）
writer＇s cramp; ventralis intermedius nucleus of thalamotomy
Objective To explore the efficacy and safety of stereotactic selective thalamotomy for the treatment of writer＇s cramp（ WC）. Methods 47 patients（ 32 men,15 women,age 15- 64 years,mean 28. 9 years） with medically intractable task-specific focal dystonia of the hand underwent Vim thalamotomy. The stereotactic target was chosen at ventralis intermedius nucleus.The mean duration of the symptom ranged from 2 to 21 years（ mean 5. 5 years）. Results All patients showed immediate postoperative disappearance of dystonic symptoms,and the effect was sustained during the follow-up period（ 6-36 months,mean 23 months）,except in 3 cases. One patient showed partial recurrence of the symptom and underwent second thalamotomy 6 months after the initial surgery with satisfactory results. The score on WC rating sca
ISSN:1672-7770
DOI:10.3969/j.issn.1672-7770.2016.06.004