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KMID : 0359819960250020352
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Journal of Korean Neurosurgical Society
1996 Volume.25 No. 2 p.352 ~ p.359
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MRI-guided Stereotactic Thalamotomy for Cerebral Palsy Patients of Mixed Dyskinesia
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Abstract
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Afew neurosurgical alleviate to alleviate some dyskinesias of cerebral palsy (CP) HAVE BEEN TRIED. For the spastic and tremor type. the selective posterior rhizotomy and thalamotomy are regarded as treatments of choice but other dyskinesias
remains
a
tough challenge. The authors have performed 48 cases of MRI-guided stereotactic thalamotomy (MGST) in 37 CP patients with mixed dyskinesias from Jun '92 to Jan *95 using CRW stereotactic frame and MRI. without any ventriculogram. Depending upon
the
types of main dyskinesias. the target including ventrolateral nucleus of thalamus or medial nucleus of globus pallidus was (were) selected. Clinical results were verified in terms of preoperative symptoms improvement and patient's satisfaction.
In
athetoid (42 MGSTs in 32 CPs) excellent 6. good 26. fair 10. and in dystonia (30 MGSTs in 23 CPs) : excellent 2. good 18. fair 10 and in spasticity (20 in 17 CPs) excellent 3. good 12 fair 5 and in choreoor choreoathetoid (7 in 6 CPs) : good 5.
fair 2.
Recurrence of symptoms aftor operation was noted in 6 cases (12.5%). Postoperative morbidity including motor weakness. speech disturbance swallowing difficulty. and sensory abnormality were transiently noted in 9 cases (18.8%). it is the authors
observation that MGST seems to be one of the beneficial procedures for relieving symptoms of CP with mixed dyskinesias.
*
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KEYWORD
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