1. Deep brain stimulation treated dystonia-trajectory via status dystonicus
- Author
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Christophe Milési, Philippe Coubes, Diane Demailly, Emilie Chan Seng, Pierre-François Perrigault, Diane Ruge, Frédéric Greco, Agathe Roubertie, Thomas Roujeau, Laura Cif, Victoria Gonzalez, Alain Boularan, Elodie Nerrant, Gilles Cambonie, Xavier Vasques, Isabel De Antonio Rubio, and Fabienne Cyprien more...
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0301 basic medicine ,Dystonia ,Pediatrics ,medicine.medical_specialty ,Deep brain stimulation ,medicine.diagnostic_test ,Pediatric onset ,business.industry ,medicine.medical_treatment ,Magnetic resonance imaging ,medicine.disease ,Status dystonicus ,3. Good health ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Neurology ,Cohort ,medicine ,Neurology (clinical) ,Young adult ,business ,030217 neurology & neurosurgery ,Cohort study - Abstract
BACKGROUND: Status dystonicus (SD) is a life-threatening condition. OBJECTIVE AND METHODS: In a dystonia cohort who developed status dystonicus, we analyzed demographics, background dystonia phenomenology and complexity, trajectory previous to-, via status dystonicus episodes, and evolution following them. RESULTS: Over 20 years, 40 of 328 dystonia patients who were receiving DBS developed 58 status dystonicus episodes. Dystonia was of pediatric onset (95%), frequently complex, and had additional cognitive and pyramidal impairment (62%) and MRI alterations (82.5%); 40% of episodes occured in adults. Mean disease duration preceding status dystonicus was 10.3 \textpm 8 years. Evolution time to status dystonicus varied from days to weeks; however, 37.5% of patients exhibited progressive worsening over years. Overall, DBS was efficient in resolving 90% of episodes. CONCLUSION: Status dystonicus is potentially reversible and a result of heterogeneous conditions with nonuniform underlying physiology. Recognition of the complex phenomenology, morphological alterations, and distinct patterns of evolution, before and after status dystonicus, will help our understanding of these conditions. \textcopyright 2018 International Parkinson and Movement Disorder Society. more...
- Published
- 2018
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