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By Jin Woo Chang, Yoichi Katayama, Takamitsu Yamamoto

ISBN-10: 321135204X

ISBN-13: 9783211352045

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In the beginning, the sternocleidomastoid muscle (SCM) and the accessory nerve were the target of surgical intervention. Then the importance of the posterior neck muscles, mainly the splenius muscle (SPL), was recognized. In order to denervate the accessory and cervical spinal nerves innervating to SCM and SPL, intradural rhizotomy was started, with some benefit. But inadequate denervation of SPL and complications due to denervation of normal muscles, turned out to be a problem. Some performed spinal cord stimulation to mimic sensory trick phenomenon.

G. Zhang et al. Flair weighted images and the coordinates were calculated automatically by Surgiplan system. The patient was operated on under local anesthesia. Intraoperative microelectrode recording was used to verify the firing pattern of STN. , electrode 3389) were implanted bilaterally in STN. Intraoperative physiological test ensured the appropriate response of the patient and no obvious adverse effect. , Kinetra) was implanted subcutaneously in the subclavicular region. The stimulator started to work 2–3 weeks later and was programmed several times till the most ideal effects occurred.

Jp Acta Neurochir Suppl (2006) 99: 29–31 # Springer-Verlag 2006 Printed in Austria Multimodal neurosurgical strategies for the management of dystonias T. Taira, T. Ochiai, S. Goto, and T. Hori Department of Neurosurgery, Neurological Institute, Tokyo Women’s Medical University, Tokyo, Japan Summary Dystonia have many subtypes, and is classified as focal, segmental and generalized. As for focal dystonia, spasmodic torticollis (cervical dystonia) and writer’s cramp are most common. Cervical dystonia is mainly treated effectively with selective peripheral denervation, and task specific focal dystonia of the hand (writer’s cramp) is effectively alleviated by stereotactic ventro-oral thalamotomy.

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