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Selective peripheral denervation for cervical dystonia: long-term follow-up

OBJECTIVE: 61 procedures with selective peripheral denervation for cervical dystonia were retrospectively analysed concerning surgical results, pain, quality of life (QoL) and recurrences. METHODS: The patients were assessed with the Tsui torticollis scale, Visual Analogue Scale (VAS) for pain and F...

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Autores principales: Bergenheim, A Tommy, Nordh, Erik, Larsson, Eva, Hariz, Marwan I
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4680147/
https://www.ncbi.nlm.nih.gov/pubmed/25362089
http://dx.doi.org/10.1136/jnnp-2014-307959
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author Bergenheim, A Tommy
Nordh, Erik
Larsson, Eva
Hariz, Marwan I
author_facet Bergenheim, A Tommy
Nordh, Erik
Larsson, Eva
Hariz, Marwan I
author_sort Bergenheim, A Tommy
collection PubMed
description OBJECTIVE: 61 procedures with selective peripheral denervation for cervical dystonia were retrospectively analysed concerning surgical results, pain, quality of life (QoL) and recurrences. METHODS: The patients were assessed with the Tsui torticollis scale, Visual Analogue Scale (VAS) for pain and Fugl-Meyer scale for QoL. Evaluations were performed preoperatively, early postoperatively, at 6 months, then at a mean of 42 (13–165) months. All patients underwent electromyogram at baseline, which was repeated in cases who presented with recurrence of symptoms after surgery. RESULTS: Six months of follow-up was available for 55 (90%) of the procedures and late follow-up for 34 (56%). The mean score of the Tsui scale was 10 preoperatively. It improved to 4.5 (p<0.001) at 6 months, and 5.3 (p<0.001) at late follow-up. VAS for pain improved from 6.5 preoperatively to 4.2 (p<0.001) at 6 months and 4 (p<0.01) at late follow-up. The Fugl-Meyer score for QoL improved from 43.3 to 46.6 (p<0.05) at 6 months, and to 51.1 (p<0.05) at late follow-up. Major reinnervation and/or change in the dystonic pattern occurred following 29% of the procedures, and led in 26% of patients to reoperation with either additional denervation or pallidal stimulation. CONCLUSIONS: Selective peripheral denervation remains a surgical option in the treatment of cervical dystonia when conservative measures fail. Although the majority of patients experience a significant relief of symptoms, there is a substantial risk of reinnervation and/or change in the pattern of the cervical dystonia.
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spelling pubmed-46801472015-12-18 Selective peripheral denervation for cervical dystonia: long-term follow-up Bergenheim, A Tommy Nordh, Erik Larsson, Eva Hariz, Marwan I J Neurol Neurosurg Psychiatry Movement Disorders OBJECTIVE: 61 procedures with selective peripheral denervation for cervical dystonia were retrospectively analysed concerning surgical results, pain, quality of life (QoL) and recurrences. METHODS: The patients were assessed with the Tsui torticollis scale, Visual Analogue Scale (VAS) for pain and Fugl-Meyer scale for QoL. Evaluations were performed preoperatively, early postoperatively, at 6 months, then at a mean of 42 (13–165) months. All patients underwent electromyogram at baseline, which was repeated in cases who presented with recurrence of symptoms after surgery. RESULTS: Six months of follow-up was available for 55 (90%) of the procedures and late follow-up for 34 (56%). The mean score of the Tsui scale was 10 preoperatively. It improved to 4.5 (p<0.001) at 6 months, and 5.3 (p<0.001) at late follow-up. VAS for pain improved from 6.5 preoperatively to 4.2 (p<0.001) at 6 months and 4 (p<0.01) at late follow-up. The Fugl-Meyer score for QoL improved from 43.3 to 46.6 (p<0.05) at 6 months, and to 51.1 (p<0.05) at late follow-up. Major reinnervation and/or change in the dystonic pattern occurred following 29% of the procedures, and led in 26% of patients to reoperation with either additional denervation or pallidal stimulation. CONCLUSIONS: Selective peripheral denervation remains a surgical option in the treatment of cervical dystonia when conservative measures fail. Although the majority of patients experience a significant relief of symptoms, there is a substantial risk of reinnervation and/or change in the pattern of the cervical dystonia. BMJ Publishing Group 2015-12 2014-10-31 /pmc/articles/PMC4680147/ /pubmed/25362089 http://dx.doi.org/10.1136/jnnp-2014-307959 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/
spellingShingle Movement Disorders
Bergenheim, A Tommy
Nordh, Erik
Larsson, Eva
Hariz, Marwan I
Selective peripheral denervation for cervical dystonia: long-term follow-up
title Selective peripheral denervation for cervical dystonia: long-term follow-up
title_full Selective peripheral denervation for cervical dystonia: long-term follow-up
title_fullStr Selective peripheral denervation for cervical dystonia: long-term follow-up
title_full_unstemmed Selective peripheral denervation for cervical dystonia: long-term follow-up
title_short Selective peripheral denervation for cervical dystonia: long-term follow-up
title_sort selective peripheral denervation for cervical dystonia: long-term follow-up
topic Movement Disorders
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4680147/
https://www.ncbi.nlm.nih.gov/pubmed/25362089
http://dx.doi.org/10.1136/jnnp-2014-307959
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