Objective: The objective of the present study was to determine the outcomes of pallidotomy in dystonia patients in a developing nation.

Background: Pallidotomy is one of the oldest surgical procedure to be used in the management of movement disorders. There was decline in the popularity of pallidotomy, earlier with the advent of levodopa, and later with the advent of deep brain stimulation (DBS). DBS is preferred over pallidotomy as it is reversible. However, there are few settings in which pallidotomy is preferred over DBS like when the risk of infection is high and when resources are limited.

Methods: All patients who underwent bilateral pallidotomy at our centre, a tertiary care hospital in north India were included in the study. The study duration was from July 2014 to September 2017. Data of all these patients was retrieved from the computerized database of our hospital.

Results: Thirteen patients underwent pallidotomy during the study period. Mean age was 21 years (range 6 to 40 years). There were 6 children (< 18 year) in our study group. Male to female ratio was 11:2. All the patients had generalized dystonia except one, who had cervical dystonia. Six patients had primary dystonia while other patients had secondary dystonia. The various aetiologies of secondary dystonia were hypoxic ischemic encephalopathy, post-encephalitic, wilson's disease and pantothenate kinase associated neurodegeneration. Mean symptom duration was 6.1 years, with one patient having the dystonia for 18 years. Twelve patients showed improvement in BFMDRS score in postoperative period. Two patients did not have any significant improvement in their symptoms. Two patients developed bulbar symptoms in post-operative period while the rest of patients did not have any significant post-operative complications.

Conclusions: Pallidotomy is a still a viable option in patients with dystonia in developing nations where patients cannot afford DBS. The patients with primary dystonia showed better improvement. However, one should be careful about the possibility of serious side effects.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/pallidotomy-in-dystonia-experience-from-a-tertiary-care-centre-in-a-developing-country/