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  • Musician's Dystonia Treated with Stereotactic Ventro-oral Thalamotomy

    Final Number:
    542

    Authors:
    Prajakta Suresh Ghate MBBS, DNB Neurosurgery; Takaomi Taira MD PhD; Shiro Horisawa

    Study Design:
    Clinical Trial

    Subject Category:
    Movement Disorders

    Meeting: 2018 ASSFN Biennial Meeting

    Introduction: Focal hand dystonia in musicians, also called Musician’s Dystonia, is a task specific movement disorder, characterized by abnormal twisting or involuntary finger movements and/or postures, manifested only while playing a particular musical instrument. It may lead to music performance career interruption or even termination of job of the affected professional musicians. Majority of the treatments available today are yet to furnish consistent and satisfactory outcome. We present the follow-up results of 64 musician’s dystonia patients treated with Ventro-oral thalamotomy.

    Methods: 64 patients with medically intractable task-specific focal hand dystonia evident only while playing musical instruments and undergoing stereotactic Ventro-oral thalamotomy between October, 2003 and September, 2017 were included in our study. We used the Tubiana scale to evaluate these patients before and after the thalamotomy. The Tubiana scale stages were recorded on subsequent follow-up along with monitoring for adverse events and were statistically analyzed.

    Results: Immediate post Ventro-oral thalamotomy improvement of dystonic symptoms was observed in all except 2 patients (96.9%). 4 patients had recurrence or deterioration of dystonic symptoms during follow-up. The mean follow-up duration was 25.1 months. No adverse events were encountered.

    Conclusions: This study confirms favorable outcome of musician’s dystonia patients treated with Ventro-oral thalamotomy showing excellent improvement in dystonic symptoms, along with preservation of this effect for a considerable duration at follow-up.

    Patient Care: Stereotactic Ventro-oral thalamotomy can aid patients with musician’s dystonia by providing relief from disabling task specific dystonic symptoms and restoring their musical performance abilities thereby resuming their jobs and professional careers, restoring their sources of income and overall improving their quality of life.

    Learning Objectives: Musician’s dystonia is a potentially disabling task specific dystonia often impacting the musician’s livelihood and resulting in end of musical performance career.Standard therapeutic treatment promising satisfactory and consistent outcome is yet to be identified. Stereotactic Ventro-oral thalamotomy can provide a favorable outcome in patients with medically refractory task-specific musician’s dystonia. With significant progress in the surgical aspects of stereotactic thalamotomy over the decades and introduction of modern equipment in the operating room, Ventro-oral thalamotomy can prove to be encouraging for beneficial results.

    References:

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