The experience of pediatric deep brain stimulation (DBS) of the globus pallidus internus (GPi) in the treatment of early-onset DYT1 generalized dystonia is still limited. Here, we report the surgical experience of bilateral GPi-DBS under general anesthesia by using microelectrode recording in a 7-year-old girl with early-onset DYT1 generalized dystonia. Excellent improvement of her dystonia without neurological complications was achieved. This case report demonstrates that GPi-DBS is an effective and safe method for the treatment of medically refractory early-onset DYT1 generalized dystonia in children.
Anesthesia, General ; Child ; Deep Brain Stimulation ; Dystonia ; Globus Pallidus ; Humans ; Microelectrodes

OBJECTIVE: The purpose of this study was to analyze in detail the relationship between outcome and time course of effect in medically refractory primary cervical dystonia (CD) with phasic type that was treated by bilateral globus pallidus internus (Gpi) deep brain stimulation (DBS). METHODS: Six patients underwent bilateral implantation of DBS into the Gpi under the guide of microelectrode recording and were followed for 18.7 +/- 11.1 months. The mean duration of the CD was 5.8 +/- 3.4 years. The mean age at time of surgery was 54.2 +/- 10.2 years. Patients were evaluated with the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) and relief scale using patient self-reporting. RESULTS: The TWSTRS total scores improved by 64.5%, 65.5%, 75.8%, and 76.0% at 3, 6, 12 months, and at the last available follow-up after surgery, respectively. Statistically significant improvements in the TWSTRS scores were observed 3 months after surgery (p = 0.028) with gradual improvement up to 12 months after surgery, thereafter, the improvement was sustained. However, there was no statistically significant difference between the scores at 3 and 12 months. Subjective improvement reported averaged 81.7 +/- 6.8% at last follow-up. Mild dysarthria, the most frequent adverse event, occurred in 3 patients. Conclusions: Our results show that the bilateral Gpi-DBS can offer a significant therapeutic effect from 3 months postoperatively in patients with primary CD with phasic type, without significant side effects.
Deep Brain Stimulation ; Dysarthria ; Follow-Up Studies ; Globus Pallidus ; Humans ; Microelectrodes ; Torticollis

Hemiballism is a ballistic, involuntary movement disorder, usually of a sudden onset, an often occurs due to encephalomalasic lesion, mostly an infarction, of deep structure of contralateral cerebral hemisphere, rarely by a small hemorrhage. The lesion site is thought to be mainly subthalamic nucleus contralateral to the abnormal movement. But there have been several reports on hemiballism without involvement of subthalmic nucleus throughout the world. We report a case of acute vascular hemiballism occurred due to a small hemorrhage with involvement of left putamen and globus pallidus, which was demonstrated by computed tomography and magnetic resonance imaging study of brain.
Brain ; Cerebrum ; Dyskinesias* ; Globus Pallidus ; Hemorrhage ; Infarction ; Magnetic Resonance Imaging ; Putamen ; Subthalamic Nucleus

A few neurosurgical alleviate to alleviate some dyskinesias of cerebral palsy(CP) have been tried. For the spastic and tremor type, the selective posterior rhizotomy and thalamotomy are regarded as treatments of choice but other dyskinesias remains a tough challenge. The authors have performed 48 cases of MRI-guided stereotactic thalamotomy(MGST) in 37 CP patients with mixed dyskinesias from Jun. '92 to Jan. '95 using CRW stereotactic frame and MRI, without any ventriculogram. Depending upon the types of main dyskinesias, the target including ventrolateral nucleus of thalamus or medial nucleus of globus pallidus was(were) selected. Clinical results were verified in terms of preoperative symptoms improvement and patient's satisfaction. In athetoid(42 MGSTs in 32CPs) : excellent 6, good 26, fair 10, and in dystonia(30 MGSTs in 23 CPs): excellent 2, good 18, fair 10, and in spasticity(20 in 17 CPs): excellent 3, good 12, fair 5, and in choreoor choreoathetoid(7 in 6 CPs) : good 5, fair 2. Recurrence of symptoms after operation was noted in 6 cases(12.5%). Postoperative morbidity including motor weakness, speech disturbance, swallowing difficulty, and sensory abnormality were transiently noted in 9 cases(18.8%). It is the authors observation that MGST seems to be one of the beneficial procedures for relieving symptoms of CP with mixed dyskinesias.
Cerebral Palsy* ; Deglutition ; Dyskinesias* ; Globus Pallidus ; Humans ; Magnetic Resonance Imaging ; Muscle Spasticity ; Recurrence ; Rhizotomy ; Thalamus ; Tremor

Among the series of 272 cases of surgically treated anterior circulation aneurysms, we experienced 6 cases of central infarctions involving caudate nucleus, globus pallidus, putamen and genu of internal capsule respectively or in combination. These surgery related complications were caused by the injury to the perforators going to the anterior perforated substance during manipulation of the large aneurysm or the aneurysms ruptured prematurely. The clinical courses of these patients, however, were not so severe. The morbidities were minimal or none after the average follow-up periods of 17 months. Thorough knowledge of the anatomy of the perforators may help to minimize the severe morbidity in the management of large or difficult aneurysms.
Aneurysm* ; Caudate Nucleus ; Follow-Up Studies ; Globus Pallidus ; Humans ; Infarction* ; Internal Capsule ; Olfactory Pathways ; Putamen

Chorea-acanthocytosis (ChAc) is a rare hereditary disorder characterized by involuntary choreiform movements and erythrocytic acanthocytosis. Pharmacotherapy for control of involuntary movements has generally been of limited benefit. Deep brain stimulation (DBS) has recently been used for treatment of some refractory cases of ChAc. We report here on the effect of bilateral high-frequency DBS of globus pallidus interna in a patient with ChAc.
Abetalipoproteinemia ; Chorea ; Deep Brain Stimulation* ; Drug Therapy ; Dyskinesias ; Globus Pallidus* ; Humans ; Neuroacanthocytosis*

Parasites are recorded from the red squirrel, Sciurus vulgaris, from Cheongju, the Republic of Korea. A total of 5 road-killed squirrels were thoroughly examined for internal and external parasites from November 2011 to May 2014. Total 4 parasite species, including 1 tapeworm and 3 ectoparasite species were recovered. They were morphologically identified as Catenotaenia dendritica (Cestoda: Catenotaeniidae), Hirstionyssus sciurinus, Leptotrombidium pallidum, and Ceratophyllus (Monopsyllus) indages. Among them, C. dendritica and H. sciurinus are recorded for the first time in the Korean parasite fauna. In addition, the possibility that the red squirrel could act as a reservoir host for a zoonotic disease like tsutsugamushi disease with L. pallidum as its vector has been raised.
Cestoda ; Chungcheongbuk-do* ; Globus Pallidus ; Korea* ; Parasites ; Republic of Korea ; Sciuridae* ; Scrub Typhus ; Trombiculidae ; Zoonoses

OBJECTIVES: The objectives of this study were to clarify which biological manganese exposure indices reflect the pallidal signal intensities in magnetic resonance imaging (MRI) in liver cirrhotics. METHODS: We examined whole blood, plasma, RBC and urinary manganese concentrations, as well as, brain MRI in 22 cirrhotic patients and 10 healthy controls. From MRI scans we calculated the signal intensity of the globus pallidus using the pallidal index (PI), the ratio of the globus pallidus to subcortical frontal white-matter signal intensity in axial T1-weighted MRI planes multiplied by 100. In addition, we studied the relationships between PI and other measurements. RESULTS: The high signal intensity in the globus pallidus on T1-weighted MRI was observed in 18 (81.8%) patients. There was a significant correlation between whole blood and RBC manganese concentration, and PI on MRI. According to multiple linear regression, whole blood and RBC manganese concentration reflected PI on MRI better the other indices did. CONCLUSIONS: Whole blood and RBC manganese concentrations could be useful as biological manganese exposure indices that reflect PI on MRI.
Brain ; Globus Pallidus ; Humans ; Linear Models ; Liver* ; Magnetic Resonance Imaging* ; Manganese* ; Plasma

The author analysed CT findings and long-term outcomes of 67 patients with acute carbon monoxide poisoning. Low density lesions were demonstrated in 44 patients (65.7%). Hemorrhage and calcification also showed with low density lesions in 3 and 2 patients, respectively. The most common findings, seen in 22 patients, was bilaterally symmetrical round low density lesion in the globus pallidus and adjacent area of internal capsule with variable sizes. In 18 patients there were diffuse symmetrical low density lesion in the cerebral white matter, especially around the centrum semiovale, with slight or marked extension. Of 44 patients with CT abnormalities seven patients recovered without disability, fifteen recovered with some disability, eighteen remained in the vegetative state, and four died. The outcome of acute carbon monoxide poisoning depended on the severity of the cerebral white matter change in CT of brain. The size of the bilateral globus pallidus lesion was not heopful to determine the longterm outcome of acute carbon monoxide poisoning.
Brain* ; Carbon Monoxide Poisoning* ; Carbon Monoxide* ; Carbon* ; Globus Pallidus ; Hemorrhage ; Humans ; Internal Capsule ; Persistent Vegetative State

OBJECTIVE: The purpose of this study is to investigate the effect of ipsilateral subthalamic nucleus(STN) lesioning on the spontaneous behavioral changes and the alteration of neuronal activities of deep cerebral nuclei in the rat parkinsonian model with 6-hydroxydopamine(6-OHDA). METHODS: To identify the spontaneous behavioral changes, apomorphine-induced rotational test and forepaw adjusting step were performed. We subsequently investigated the alteration of neuronal activities in the substantia nigra pars reticulata(SNpr) and globus pallidus(GP), in order to compare them with the behavioral changes in rat parkinsonian models. RESULTS: The STN lesioning in the rat parkinsonian model clearly improved behavioral changes. Compared to the normal control rats, rat PD models exhibited a significant increase in mean firing rates and the percentage of bursting neurons in the STN and SNpr. In the STN-lesioned rat PD models, mean firing rates and the percentage of bursting neurons in the SNpr were reduced and those in the GP increased. CONCLUSION: STN lesioning induced behavior improvement in rat parkinsonian models seems to be consistent with the surgical outcomes of the STN stimulation therapy in advanced Parkinsonn's disease(PD). The alteration of the neuronal activities in the SNpr and GP suggests that these sites are responsible for the improvement of parkinsonian motor symptoms observed following STN lesioning in rat parkinsonian models. The significance of bursting activity in the SNpr and GP remains obscure. Further study is necessary to elucidate the pathophysiological mechanism of PD.
Animals ; Fires ; Globus Pallidus ; Kainic Acid* ; Neurons* ; Oxidopamine* ; Parkinson Disease ; Rats* ; Substantia Nigra ; Subthalamic Nucleus