Objective: To report and compare the outcomes of functional neurosurgical procedures for treatment of secondary hemidystonia performed at Hospital das Clinicas in São Paulo (HC-FMUSP).

Background: Hemidystonia is a common type of secondary dystonia, which has limited pharmacological treatment and poor response to botulin toxin. Until now, DBS has shown insufficient results for secondary dystonia, meanwhile ablative procedure seems to be suitable for this kind of unresponsive neurological disorder.

Methods: This is a retrospective study involving 12 patients who underwent continuous intrathecal baclofen pump (CITB, n=4), pallidotomy (n=4) or ventral-oral posterior thalamotomy with zona incerta lesion (VOP/Zi, n=4) since 2007. The clinical response to the procedures was measured by the questionnaire of global outcome score (GOS) and clinical global impression (CGI).

Results: The average follow up was 3 years (SD= +-2.3 years), with a maximum of 8 years. Five of 12 patients (41.6%) had cerebral palsy associated spacitity or magnetic resonance images changes suggestive of perinatal hypoxia. The VOP/Zi group had GOS and CGI in comparison to pallidotomy and CITB. The GOS and CGI scales didn’t show significant difference between for pallidotomy and CITB.

Conclusions: Interestingly the VOP/Zi lesioned group achieved better and sustained results, when compared to the other techniques evaluated. Future prospective and controlled studies should be performed to confirm these results.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/long-term-comparative-outcomes-of-functional-neurosurgical-procedures-for-treatment-of-secondary-hemidystonia/