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Neurol India. 2019 Nov-Dec;67(6):1515-1518. doi: 10.4103/0028-3886.273644.

Gamma Knife Radiosurgical Pallidotomy for Dystonia: Not a Fallen Angel.

Author information

1
Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
2
Jain Institute of Movement Disorders and Stereotactic Neurosurgery, Bangalore, Karnataka, India.
3
Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
4
Department of Neurosurgery, National Institute of Medical Health and Neurosciences, Bangalore, Karnataka, India.
5
Department of Radiotherapy, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
6
Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Abstract

The authors report a case of successful management of right side hemidystonia with gamma knife radiosurgery. A 24-year-old male with a history of birth asphyxia subsequently developed worsening right-sided torsional hemidystonia which failed to respond to the medical management. MRI of the brain was unremarkable. Stereotactic gamma knife radiosurgery (GKRS) was performed to create a lesion in the left posteroventral globus pallidum. The patient gradually improved over a course of 18 months without any complication. He obtained 61% improvement in dystonia rating scale. Radiosurgical pallidotomy is often viewed with suspicion and functional neurosurgeons show reluctance in preferring it to stereotactic radio frequency lesioning or stimulation surgery. The authors would like to highlight the chances of not only control, but also cure of the disease with this cost-effective treatment modality.

KEYWORDS:

Dystonia; Gamma-knife; pallidotomy; stereotactic radiosurgery

PMID:
31857549
DOI:
10.4103/0028-3886.273644
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