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Title: Clinical Outcome After Pallidal Surgery For Secondary Generalised Dystonia.
e-poster Number: INSIM85
Category: Neurosurgery
Author Name: Alay V Khandhar
Institute: P. D. Hinduja Hospital, Mumbai
Co-Author Name: Milind Sankhe
Abstract :
Introduction : Surgical intervention is generally believed to be less effective in secondary dystonia than primary cases of dystonia. There are few reports and case series with favourable outcomes following surgery in secondary dystonias. However, the outcome reported in literature is variable owing to the heterogeneity in clinical pattern of dystonia.
Aims & Objectives : This study shows long term results in patients with secondary generalised dystonia treated with pallidal procedures including lesioning and deep brain stimulation(DBS) of globus pallidus internus(GPi) at our tertiary referral centre from years 2004 to 2022.
Material & Methods : The study includes 18 cases of secondary generalised dystonia, 5 cases of Kernicterus, 5 of Pantothenate Kinase Associated Neurodegeneration(PKAN), 3 of birth asphyxia, 2 with unknown aetiology, 1 case each of post-traumatic, Lesch-Nyhan Syndrome(LNS) and Wilson's disease. All the patients were evaluated using Burke Fahn Marsden Dystonia Rating Scale(BFMDRS), before surgery(0 months) and at 6-12-24 months post-surgery. On repeated measures ANOVA analysis, there was significant difference at different time points (0-6-12-24 months) p-value=0.0345.
Results : The percentage change at 24 months follow-up post-surgery were 101.18%, 52.87%, 51.71%, 43.14%, 8.93%, 8.00%, 4.79% and 4.51% in post-traumatic, unknown aetiology, late-onset PKAN, Wilson's disease, LNS, birth asphyxia, early-onset PKAN and Kernicterus respectively.
Conclusion : Despite the general belief that secondary dystonia does not respond fairly to pallidal procedures, certain causes as evident in our study have achieved significant reduction in disability which is comparative to the results obtained for primary dystonia.
