■脑瘫(CP),具有多种病因的复杂综合征,其特征在于运动机能减退和运动机能亢进谱内的一系列运动障碍(肌张力障碍或舞蹈性动脉粥样硬化)。CP通常伴有神经和精神体征,比如痉挛,共济失调,和认知障碍。尽管目前CP的治疗选择包括药物干预,康复计划,和痉挛缓解手术,其有效性仍然有限。脑深部电刺激(DBS)已证明在控制运动障碍方面具有显著的有效性;然而,其对CP的潜在治疗效果仍有待确定。
■我们介绍了一例44岁的亚裔女性,她出生时是双胞胎,因分娩时间延长而患有新生儿缺血性缺氧性脑病。她在1岁时被诊断出患有CP。与同龄人相比,患者表现出发育延迟,并出现各种症状,包括含糊不清的演讲,广泛的步态,右下肢的马蹄形倒置,上肢的双侧无意识的晃动,和低张力,左旋多巴治疗没有改善。两年前,她出现了进行性头部震颤,在紧张期间恶化并在睡眠期间改善。由于药物治疗被证明是无效的,并且没有手术禁忌症,我们进行了双侧苍白球internaDBS(GPi-DBS)以减轻她的运动功能障碍。
■经过6个月的随访,患者表现出运动症状的显着改善,包括头部和四肢震颤和肌张力障碍。此外,她的整体心理健康状况得到了显着改善,焦虑和抑郁水平降低证明了这一点。
■DBS是治疗成人与CP相关的运动障碍症状的有效方法。此外,随着时间的推移,其有效性可能会继续增加。
UNASSIGNED: Cerebral palsy (CP), a complex syndrome with multiple etiologies, is characterized by a range of movement disorders within the hypokinetic and hyperkinetic spectrum (dystonia or choreoathetosis). CP is often accompanied by neurological and psychiatric signs, such as spasticity, ataxia, and cognitive disorders. Although current treatment options for CP include pharmacological interventions, rehabilitation programs, and spasticity relief surgery, their effectiveness remains limited. Deep brain stimulation (DBS) has demonstrated significant effectiveness in managing dyskinesia; however, its potential therapeutic effect on CP remains determined.
UNASSIGNED: We present a case of a 44-year-old Asian female who was born as a twin with neonatal ischemic-hypoxic encephalopathy due to prolonged labor and delivery. She was diagnosed with CP at the age of 1 year. The patient exhibited delayed development compared to her peers and presented with various symptoms, including slurred speech, broad-based gait, horseshoe inversion of the right lower extremity, involuntary shaking of the upper extremities bilaterally, and hypotonia and showed no improvement with levodopa therapy. Two years ago, she developed progressive head tremors, which worsened during periods of tension and improved during sleep. As medical treatments proved ineffective and there were no contraindications to surgery, we performed bilateral globus pallidus interna DBS (GPi-DBS) to alleviate her motor dysfunction.
UNASSIGNED: Following a 6-month follow-up, the patient demonstrated significant improvements in motor symptoms, including head and limb tremors and dystonia. In addition, significant improvement was observed in her overall psychological well-being, as evidenced by reduced anxiety and depression levels.
UNASSIGNED: DBS is an effective treatment for dyskinesia symptoms associated with CP in adults. Moreover, its effectiveness may continue to increase over time.