Globus Pallidum DBS for Task-Specific Dystonia in a Professional Golfer Cover

Globus Pallidum DBS for Task-Specific Dystonia in a Professional Golfer

Tremor and Other Hyperkinetic Movements

Volume 8 (2018): Issue 0

By: Aparna Wagle Shukla, Wei Hu, Zakia Jabarkheel, Syed Shah, Joseph Legacy, Kamilia Nozile Firth, Pam Zeilman, Kelly Foote and Michael S. Okun

Open Access

|Oct 2018

Figures & Tables

MRI Targeting and Atlas Mapping for DBS Lead. Deep brain stimulation (DBS) leads were stereotactically implanted in the ventroposterolateral globus pallidus (GPi) and were localized with magnetic resonance imaging (MRI) and microelectrode mapping. A quadripolar electrode (Model 3387; Medtronic, MN) with four contacts numbered 0 (ventral) to 3 (dorsal) for the left side and numbered 8 (ventral) to 11 (dorsal) for the right side was implanted. The GPi lead location on postoperative computed tomography was fused with the preoperative MRI scan and measured using Schaltenbrand–Bailey’s stereotactic atlas. We confirmed a well-placed location for the DBS leads on both sides. The coordinates for the tip of the right lead were X 21.06 mm; Y 0.06 mm; Z –5.09 mm; AC–PC angle 65; centerline angle 7. The coordinates for the tip of the left lead were X 21.25 mm; Y –0.64 mm; Z –3.17 mm; anterior commissure-posterior commissure (AC–PC) angle 65; centerline angle 1. Brain MRI T2 sequence coronal (A), axial (B), and sagittal (C) views of right GPi lead location. Brain MRI T2 sequence coronal (D), axial (E), and sagittal (F) views of left GPi lead location. The red line indicates the lead trajectory. Outlines of the atlas: blue, caudate nucleus; red, globus pallidus internus; lateral green, globus pallidus externus; internal green, thalamus; yellow, optic tract.

Video 1.

Pre and Post DBS Video Illustration. Segment 1. This video illustrates the task-specific cervical dystonia manifested during swinging golf task. Dystonia manifests as sudden turning of head to the right with slight upward movement. Segment 2. This segment illustrates the remarkable improvement reported by the patient in about 6 months after surgery and programming. The patient is now able to resume competitive golf activities.

DOI: https://doi.org/10.5334/tohm.428 | Journal eISSN: 2160-8288

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Language: English

Submitted on: May 30, 2018

Accepted on: Aug 20, 2018

Published on: Oct 9, 2018

Published by: Columbia University Libraries/Information Services

In partnership with: Paradigm Publishing Services

Publication frequency: 1 issue per year

Keywords:

Task-specific cervical dystonia,

globus pallidum,

deep brain stimulation,

© 2018 Aparna Wagle Shukla, Wei Hu, Zakia Jabarkheel, Syed Shah, Joseph Legacy, Kamilia Nozile Firth, Pam Zeilman, Kelly Foote, Michael S. Okun, published by Columbia University Libraries/Information Services
This work is licensed under the Creative Commons License.

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