引起复视和Esophoria内侧丘脑脑深部电刺激(P6.308)

文摘

目的:描述esophoria造成内侧丘脑脑深部刺激(DBS)治疗抽动秽语综合征(TS)。背景:DBS丘脑centromedian / parafascicular复杂(CM / Pf)改善症状TS。电极刺激诱发的眼球运动异常没有被描述。设计/方法:一位44岁的衰弱TS从小耐火材料药物治疗进行了星展银行,与领导(3387美敦力公司)植入双边丘脑CM-Pf地区。铅位置离开x -4.3, -5.3 y, z 1.0 x 4.6, 0.6 -4.7 y, z。结果:DBS编程后,发生剧烈的抽搐救援,耶鲁86年全球抽搐严重程度评分改善术前术后42。最终刺激参数左7.2 mA和右6.0 mA,双边接触0 - 3 +,脉冲宽度(PW) 90年购买,130赫兹。在基线,眼球运动是完全没有esophoria。他有先天性右眼独立加合物的能力。单极审查每个联系人进行使用提升当前(mA),积极,PW 90购买,130 Hz,侧DBS。病人报道头晕和复视糟糕的目光。Esophoria离开视线诱导的左或右刺激,最严重的腹侧接触,离开导致较低的阈值(阈值左0四马联系,联系3马六,对接触0 5 mA,接触3八马)。 The esophoria spread to central position and right gaze with higher amplitude or longer duration stimulation. No abduction defect was seen. Tic relief was best with ventral contacts. CONCLUSIONS: Thalamic DBS may influence descending supranuclear convergence pathways traveling through the medial thalamus to rostral midbrain, disinhibiting convergence neurons and causing esodeviation. Left-sided predominant esophoria that spreads to central and right gaze with increasing current from either lead suggests bilateral innervation of supranuclear convergence pathways. This case may shed light on convergence pathways and explain patients' subjective diplopia and dizziness observed during medial thalamic stimulation.

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