MRI 导向丘脑腹中间核立体定向毁损术治疗书写痉挛二例并文献复习.PDF

中国现代神经疾病杂志 年 月第 卷第 期 2015 10 15 10 ChinJContempNeurolNeurosurg,October2015,Vol.15,No.10 ·809 · 功能神经外科 · · MRI导向丘脑腹中间核立体定向毁损术治疗 书写痉挛二例并文献复习 牛朝诗 丁宛海 牛万祥 陈鹏 熊赤 【摘要】 目的 探讨立体定向手术治疗书写痉挛的方法及疗效。方法与结果 采用MRI导向丘脑 腹中间核立体定向毁损术治疗 例书写痉挛（震颤型）患者，例 术后书写时震颤即消失，写字较术前工 2 1 整；例 术后右上肢震颤明显改善，可正常工作和生活。 例患者均未出现明显并发症，术后随访至今均 2 2 未复发。结论 书写痉挛的外科手术疗效明确， 导向丘脑腹中间核立体定向毁损术可以精确定位 MRI 神经核团，有效避免术中并发症。文献复习两种外科手术方法（脑深部电刺激术和脑深部神经核团毁损 术）的优劣和适应证，尚待进一步探讨。 【关键词】 张力障碍； 立体定位技术； 丘脑腹侧核； 磁共振成像 MRIguidedstereotacticventrointermediatethalamotomyforwriterscramp: twocasesreportand literaturereview NIUChao⁃shi,DINGWan⁃hai,NIUWan⁃xiang,CHENPeng,XIONGChi Department of Neurosurgery, Anhui Provincial Hospital Affiliated to Anhui Medical University; Anhui Province Key Laboratory of Brain Function and Brain Disease; Anhui Provincial Stereotactic Neurosurgical Institute, Hefei 230001, Anhui, China Corresponding author: NIU Chao shi (Email: niuchaoshi@163.com) ⁃ 【 】 Abstract Objective To explore the methods and curative effect of stereotactic surgery for treating writers cramp (WC). Methods and Results Two patients with writers cramp (tremor type) underwentMRIguidedstereotacticventrointermediate(Vim)thalamotomyontheleftside. Thesymptomsof onepatientdisappearedimmediatelyafteroperation,andthepatientcouldwritelegibly. Thetremorofright upper extremity in another patient was improved significantly. Two patients did not present obvious complications, and the previous symptoms were not found to recur during follow⁃up period respectively. Conclusions Stereotactic surgery for treat