Friday, June 5, 2009
Neuromodulation for dystonia - moving forward!
Dr. Erich Richter has performed deep brain stimulation to treat a patient with severe dystonia. The case was performed at West Jefferson Hospital with great results! The electrode was implanted with the use of stereotactic head frame attached to the patient's skull. (This guidance system allows for accurate placement of electrode, which delivers stimulation to affected area of the brain). Patient's symptoms, that included extreme pain and muscle spasms, significantly improved. As a matter of fact, the benefits of DBS may take several months to achieve its full effect. The result achieved by neurosurgeon at LSUHSC at New Orleans looks promising and gives new hope to prospective patients!
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How many DBS implants has Dr. Richter performed for the treatment of intractable primary dystonia, non-Parkinsons?
ReplyDeleteWhat are the functional outcomes of those he has implanted?
DBS is FDA approved for Parkinson's Disease and Essential tremor. Since opening the center here in New Orleans last year, there has been a slow growth in referrals, which have been about 1/3 for tremor. Dystonia is only FDA approved under the HDE, or humanitarian device exemption, at specific centers that perform it under IRB supervision. We recently obtained this approval at the West Jefferson site, and were able to add Childrens hospital in the last few months. More than half of the cases remain Parkinsons Disease. The dystonia cases referred to date have been secondary dystonias, which have a very variable response rate at all centers. Our results have varied from near complete resolution of the dystonia in a patient with a disabling focal hand dystonia, to very minimal improvement in a very disabled young man with concomitant severe spasticity. Over all our results are similar to other major movement disorders programs.
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