Abstract SNACC-75

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Deep Brain Stimulation for Choreoathetotic and Dystonic Cerebral Palsy: Case Report

Monsalve G, Niño C, Cohen D
Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá D.C., Cundinamar, Colombia

Introduction: Cerebral palsy related movement disorders are a disabling entity. Choreathetosis and dystonia are seen in the course of cerebral palsy.

Objective: to describe a case of cerebral palsy with choreoathetosis and dystonia successfully treated with deep brain stimulation surgery.

Case Report: this is a case of a 14-year old female patient with a history of cerebral palsy and choreoathetosis and generalized dystonia, patient had a very comprehensive rehabilitation treatment and still had a very disabling movement disorder. Patient was evaluated for an interdisciplinary team and considered good candidate for a deep brain stimulation surgery. A bilateral globus pallidus internus electrical stimulation was performed and a right pectoral implantable pulse generator was placed and connected to the system. Patient at 6-month follow-up has improved her independency and partially controlled the coreoathetosis and dystonia movements.

Conclusión: We report the case of a patient with neurological injuries that offer significant challenges for the anesthesiologist, since the young age, prolonged surgery, abnormal postures and movements complicate the administration of anesthesia. A first time under general anesthesia was required to convert then monitored anesthesia care guided by bispectral index that would make the safe location of deep brain nuclei and thereby facilitate the success of the surgical procedure. Deep brain stimulation surgery is a feasible treatment option for patients with cerebral palsy related movement disorders, it has good outcome in a very good selected patient. An interdisciplinary team must select the patient, operate and manage the patient in the post-op. A group of neuroanesthesia, and proper anesthetic intervention is mandatory for the success of this surgery.

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3. Katsakiori PF, KEfalopoulou Z, Markaki E, Paschali A, Ellul J, Kagadis GC, Chroni E, Constantoyannis C. Deep brain stimulation for secondary dystonia: results in 8 patients. Acta Neurochir 2009;151:473-478.

4. Vidailhet M, Yelnik J, Lagrange C, Fraix V, Grabli D, Thobois S, Burbaud P, Welter ML, Xie-Brustolin J, Coelho Braga MC, Ardouin C, Czernecki V, Klinger H, Chabardes S, Seigneuret E, Mertens P, Cuny E, Navarro S, Cornu P, Benabid AL, Le Bas JF, Dormont D, Hermier M, Dujardin K, Blond S, Krystkowiak P, Destée A, BArdinet E, Agid Y, Krack P, Broussolle E, Pollak P, and the French SPIDY-2 Study Group. Bilateral pallidal deep brain stimulation for the treatment of patients with dystonia-choreoathetosis cerebral palsy: a prospective pilot study. Lancet Neurol 2009;8:709-717.


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