| Objectives: To further demonstrate the efficacy and safety of bilateral subthalamic nucleus stimulation in the treatment of primary Meige syndrome and explore the significant predictors for the long-term movement improvement after surgery.Methods: Fifteen patients with primary Meige syndrome who responded poorly to medical treatments or botulinum toxin injections had undergone bilateral deep brain stimulation of subthalamic nucleus.The severity and disability of dystonia were evaluated before surgery and at final follow-up after surgery during neurostimulation,with the use of the movement and disability subscores of the Burke–Fahn–Marsden Dystonia Rating Scale.Movement scale was assessed based on preoperative and postoperative video documentation,by an independent rater who was unaware of the neurostimulation status.The quality of life was assessed with the questionnaire of Medical Outcomes Study 36-item Short-Form General Health Survey.All the complications after surgery were recorded.Results: The dystonia movement subscores improved from 19.3±7.6(mean ± standard deviation)before surgery to 5.5±4.5 at final follow-up(28.5±16.5 months),with a mean improvement of 74%(p<0.05)in 14 consecutive patients.The disability subscore improved from 15.6±4.9 before surgery to 6.1±3.5 at final follow-up(p<0.05).In addition,the postoperative SF-36 scores increased markedly,compared with baseline.We also find that bilateral stimulation of subthalamic nucleus has the advantages of immediate improvement of symptoms after stimulation and lower stimulation parameters compared with pallidal deep brain stimulation for primary Meige syndrome.No significant predictors for the long-term movement improvement after surgery were found.All the adverse events resolved without permanent sequelae.Conclusion: These findings provide further evidence to support the long-term efficacy and safety of subthalamic nucleus stimulation as an alternative treatment for patients with medically intractable Meige syndrome. |
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