Introduction: Stereotactic neurosurgery remains as a final option in severe cases of medication-resistant
hemiballismus, but is only necessary in a small proportion of patients. Surgical
options include thalamotomy and pallidotomy, both carried out alone. These procedures were reported in a few number of cases.
Methods: Four patients underwent stereotactic ablative neurosurgery. The clinical data were reviewed using the objective hemiballismus/hemichorea outcome rating score (HORS). All patient with a history of severe disabling, involuntary movement HORS = 4 to HORS =3.
Results: Two of our four patients, who underwent combined pallidotomy (GPi) /thalamotomy (Vim-Vop), presented an excellent outcome, with a mild but definite difference from the two others patients who reported improvement but not total relief
Conclusions: The combined thalamotomy and pallidotomy is a valid option for the treatment of medication-resistant hemiballismus.
Patient Care: Through an optimal approach to such hemiballismus patients.
Learning Objectives: By the conclusion of the session, participants should be able to identify an treatment option for drug-resistant hemiballismus patients.
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