혼합성 운동장애를 가진 뇌성마비 환자들에게 MRI를 이용한 뇌정위적 시상핵 파괴술의 효과
MRI-guided Stereotactic Thalamotomy for Cerebral Palsy Patients of Mixed Dyskinesia
최승제, 이규호,
소속 상세정보
최승제 ( )
국군수도통합병원
이규호 ( )
국군수도통합병원
KMID : 0359819960250020352
Abstract
Afew neurosurgical alleviate to alleviate some dyskinesias of cerebral palsy (CP) HAVE BEEN TRIED. For the spastic and tremor type. the selective posterior rhizotomy and thalamotomy are regarded as treatments of choice but other dyskinesias
remains
a
tough challenge. The authors have performed 48 cases of MRI-guided stereotactic thalamotomy (MGST) in 37 CP patients with mixed dyskinesias from Jun '92 to Jan *95 using CRW stereotactic frame and MRI. without any ventriculogram. Depending upon
the
types of main dyskinesias. the target including ventrolateral nucleus of thalamus or medial nucleus of globus pallidus was (were) selected. Clinical results were verified in terms of preoperative symptoms improvement and patient's satisfaction.
In
athetoid (42 MGSTs in 32 CPs) excellent 6. good 26. fair 10. and in dystonia (30 MGSTs in 23 CPs) : excellent 2. good 18. fair 10 and in spasticity (20 in 17 CPs) excellent 3. good 12 fair 5 and in choreoor choreoathetoid (7 in 6 CPs) : good 5.
fair 2.
Recurrence of symptoms aftor operation was noted in 6 cases (12.5%). Postoperative morbidity including motor weakness. speech disturbance swallowing difficulty. and sensory abnormality were transiently noted in 9 cases (18.8%). it is the authors
observation that MGST seems to be one of the beneficial procedures for relieving symptoms of CP with mixed dyskinesias.
*
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