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  4. Successful treatment of focal hand dystonia after cervical whiplash injury by thalamotomy

Successful treatment of focal hand dystonia after cervical whiplash injury by thalamotomy

Surgical Neurology International, 2022 · DOI: 10.25259/SNI_474_2022 · Published: August 26, 2022

NeurologyPain ManagementSurgery

Simple Explanation

This case report discusses a rare condition: focal hand dystonia (abnormal, involuntary movements and postures of the hand) that developed after a whiplash injury to the neck. The patient was successfully treated with a surgical procedure called thalamotomy, which involves creating a small lesion in a specific area of the brain (thalamus) to interrupt the abnormal signals causing the dystonia. The report suggests that this type of thalamotomy (Vo-Vim thalamotomy) can be an effective treatment option for focal hand dystonia that occurs after a whiplash injury when other treatments are not effective.

Study Duration
9 Years
Participants
1 patient: a 39-year-old woman
Evidence Level
Level 4: Case Report

Key Findings

  • 1
    The patient experienced significant improvement in hand function and was able to maintain her normal physical routine for eight years following the second surgery (Vo-Vim thalamotomy).
  • 2
    Vo-Vim thalamotomy may be a feasible and effective treatment for peripheral posttraumatic dystonia.
  • 3
    The case suggests that Vo-Vim thalamotomy can be considered as an option to treat focal hand dystonia after cervical whiplash injury.

Research Summary

This case report describes a 39-year-old woman who developed focal hand dystonia after a whiplash injury. She underwent Vo thalamotomy and later Vo-Vim thalamotomy after recurrence of dystonia. The patient was able to maintain her normal physical routine for eight years after the second surgery.

Practical Implications

Surgical Option for Rare Condition

Vo-Vim thalamotomy can be considered as a surgical treatment option for posttraumatic focal hand dystonia after cervical whiplash injury.

Target Refinement

The target should be more on the posterior side, Vim coagulation was added. The Vop-Vim may be a target for focal hand dystonia in the cases of failure of Vo thalamotomy

Individualized Treatment

Individually tailored treatment choice is important for the management of symptomatic recurrence.

Study Limitations

  • 1
    Single case report
  • 2
    It is unclear which parts of Vo and Vim should be targeted.
  • 3
    Rarity of dystonia due to whiplash

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