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Novel Approaches for Brain Diseases Are Discussed at AANS Meeting

by Lynn Shapiro, Writer | May 13, 2009

The mean follow-up time was 5.7 years, with the following outcomes:

All patients experienced more than a 50 percent improvement in pain and there were no complications related to the pump/catheter drug delivery systems.

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"In conclusion, medications delivered directly to the spinal sac through a surgically implanted drug pump can help reduce pain in shingles in patients who do not respond to oral medications," Dr. Fabiano said.

Deep Brain Stimulation for Dystonia

Dystonia is a very complex, highly variable neurological movement disorder characterized by involuntary muscle contractions. As many as 250,000 people in the United States have dystonia, making it the third most common movement disorder behind essential tremor and Parkinson's disease.

Dystonia results from abnormal functioning of the basal ganglia, a deep part of the brain, which helps control coordination of movement. Patients with generalized primary dystonia suffer from repetitive twisting movements or abnormal postures due to involuntary muscle contractions.

This can be a severely disabling disease, which starts around age 10, with initial misdiagnosis fairly common. Further, it can be a socially debilitating disease, especially for young people, since peer acceptance plays an important role during one's teen years.

Researchers at Ludwig-Maximilians University in Munich investigated the safety and efficacy of deep brain stimulation (DBS) in children with severe cases of treatment-resistant primary dystonia. The results of this study were presented by Jan H. Mehrkens, MD.

Over the last decade, the globus pallidus internus (GPi) of the basal ganglia of the brain, has been identified as the most promising target for treating dystonia. However, very little is known about long-term efficacy and side effects of using this treatment at early disease onset in children suffering from primary generalized dystonia, Dr. Mehrkens said.

In the past nine years, Dr. Mehrkens has treated 48 patients using this approach. She implanted electrodes in patients under general anesthesia with MRI-guided stereotaxy and then implanted an internal pulse generator.

The entire patient group experienced significant improvement in symptoms as early as the first week, and symptoms abated further improved in the 58 month follow-up period.

The mean improvement in the movement score was highly significant: patients enjoyed a 67.4 percent greater control over their movement at 3 months, 75.4 percent more control at 12 months and 83.5 percent more control over the long term.