Adductor Spasmodic Dysphonia Improves with Bilateral Thalamic Deep Brain Stimulation: Report of 3 Cases Done Asleep and Review of Literature

Tremor and Other Hyperkinetic Movements

article

Virgilio Gerald H. Evidente¹  Francisco A. Ponce²  Maris H. Evidente¹  Margaret Lambert²  Robin Garrett¹  Manikandan Sugumaran³  David G. Lott⁴ 

[1] Movement Disorders Center of Arizona;Barrow Neurological Institute;Banner University;Mayo Clinic Arizona

关键词: Spasmodic dysphonia;    deep brain stimulation;    DBS;    laryngeal dystonia;    thalamic DBS;    Essential Tremor;   

DOI  :  10.5334/tohm.575

学科分类：社会科学、人文和艺术（综合）

来源: Ubiquity Press

【 摘 要 】

Background: To date, there are only six published reports of adductor spasmodic dysphonia (SD) responding to awake thalamic deep brain stimulation (DBS). Methods: We retrospectively reviewed cases of Essential Tremor (ET) with SD that were seen in our center from 2012 to 2020. We further identified those that have undergone thalamic DBS, and had a blinded laryngologist rate first the audio voice recordings before and after DBS using the Unified Spasmodic Dysphonia Rating Scale (USDRS), and the video recordings last to rate the related movements and facial grimacing. Results: We identified three cases of adductor SD with ET that had undergone bilateral ventralis intermedius (VIM) DBS under general anesthesia. All patients noted improvement of their limb and voice tremor, as well as their SD post-DBS. Although improvement of tremor was observed even with initial programming in all three, improvement of SD was noted only upon reaching higher amplitudes or wider pulse widths. Blinded voice assessments showed improvement of USDRS scores post-DBS compared to pre-DBS, and with stimulator on compared to stimulator off. Discussion: We report the first three cases of SD responding favorably to bilateral VIM asleep DBS and summarize the nine cases so far of SD who have undergone thalamic DBS.

【 授权许可】

CC BY