PMC9534566_01
Patient 1' s posture before and after surgery. He presented with dyskinesia symptoms, with lateral and forward flexion in the upright position (A). He showed the same torsion dyskinesia when he was raising his legs before surgery (B). After surgery, he was able to hold his posture in the upright position and no longer required a wheelchair (C, D). Postoperative computed tomography (CT) images were combined with preoperative magnetic resonance imaging (MRI) using a Stealth Station. The deep brain stimulation (DBS) electrodes were placed bilaterally in the globus pallidus internus (GPi; white arrow); the right 1st electrode (E), right 2nd electrode (F), left 1st electrode (G), and left 2nd electrode in Case 1 (H).
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After stimulation, the dystonia symptoms almost disappeared, and the patient was completely independent without the use of a wheelchair (Fig. 1C, D).
PMC9534566_02
Patient 1' s posture before and after surgery. He presented with dyskinesia symptoms, with lateral and forward flexion in the upright position (A). He showed the same torsion dyskinesia when he was raising his legs before surgery (B). After surgery, he was able to hold his posture in the upright position and no longer required a wheelchair (C, D). Postoperative computed tomography (CT) images were combined with preoperative magnetic resonance imaging (MRI) using a Stealth Station. The deep brain stimulation (DBS) electrodes were placed bilaterally in the globus pallidus internus (GPi; white arrow); the right 1st electrode (E), right 2nd electrode (F), left 1st electrode (G), and left 2nd electrode in Case 1 (H).
2188-4226-9-0307-g001.jpg
PMC9534566_02_2188-4226-9-0307-g001.jpg
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After stimulation, the dystonia symptoms almost disappeared, and the patient was completely independent without the use of a wheelchair (Fig. 1C, D).
PMC9534566_03
Patient 2' s posture before and after surgery. He showed dyskinesia symptoms during movement, and in particular, he was observed to throw his left leg forward in a twisting motion while walking (A, B). After surgery, his symptoms markedly improved (C, D). The postoperative location of the bilateral deep brain stimulation (DBS) electrode for Case 2 (white arrow). The right 1st electrode (E), right 2nd electrode (F), left 1st electrode (G), and left 2nd electrode (H).
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However, the upper limb symptoms and throwing his left leg when walking persisted (Fig. 2A, B), so he decided to undergo GPi-DBS. The DBS electrodes were placed as planned in the fusion images between postoperative computed tomography (CT) scan and preoperative MRI. (Fig. 2E-H). Thirteen months after surgery, the dystonia symptoms had almost disappeared, and the BFMDRS motor and disability scores were 2/120 and 1/30, respectively (Fig. 2C, D).