Long-term outcome of pallidal stimulation for Meige syndrome

• Published in: Journal of neurosurgery Vol. 130; no. 1; p. 84
• Main Authors: Horisawa, Shiro, Ochiai, Taku, Goto, Shinichi, Nakajima, Takeshi, Takeda, Nobuhiko, Kawamata, Takakazu, Taira, Takaomi
• Format: Journal Article
• Language: English
• Published: United States 01.01.2019
• Subjects: Adult; Deep Brain Stimulation; Female; Follow-Up Studies; Globus Pallidus; Humans; Male; Meige Syndrome - therapy; Middle Aged; Time Factors; Treatment Outcome; Young Adult; BFMDRS = Burke-Fahn-Marsden Dystonia Rating Scale; globus pallidus internus; GPi = globus pallidus internus; Meige syndrome; craniocervical dystonia; DBS = deep brain stimulation; functional neurosurgery; BFMDRS-M = BFMDRS movement subscale; IPG = implantable pulse generator; deep brain stimulation
• ISSN: 1933-0693
• DOI: 10.3171/2017.7.jns17323

OBJECTIVE Meige syndrome is characterized by blepharospasm and varied subphenotypes of craniocervical dystonia. Current literature on pallidal surgery for Meige syndrome is limited to case reports and a few small-scale studies. The authors investigated the clinical outcomes of deep brain stimulation (DBS) of the globus pallidus internus (GPi) in patients with Meige syndrome. METHODS Sixteen patients who underwent GPi DBS at the Tokyo Women's Medical University Hospital between 2002 and 2015 were included in this study. Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) movement subscale (BFMDRS-M) scores (range 0-120) obtained at the following 3 time points were included in this analysis: before surgery, 3 months after surgery, and at the most recent follow-up evaluation. RESULTS The patients' mean age (± SD) at symptom onset was 46.7 ± 10.1 years, and the mean disease duration at the time of the authors' initial evaluation was 5.9 ± 4.1 years. In 12 patients, the initial symptom was blepharospasm, and the other 4 patients presented with cervical dystonia. The mean postoperative follow-up period was 66.6 ± 40.7 months (range 13-150 months). The mean total BFMDRS-M scores at the 3 time points were 16.3 ± 5.5, 5.5 ± 5.6 (66.3% improvement, p < 0.001), and 6.7 ± 7.3 (58.9% improvement, p < 0.001). CONCLUSIONS The results indicate long-term efficacy for GPi DBS for the majority of patients with Meige syndrome.