This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Focal hand dystonia (FHD) is a primary dystonia produced by the excessive co-contraction of antagonistic muscles of the hand and forearm.1,2 Although deep brain stimulation (DBS) is now recognized as a beneficial option to treat a wide spectrum of dystonias,3 little is known regarding its effects on FHD. This is a report of DBS of the thalamic Vo-complex nucleus or the globus pallidus internus (GPi) effecting the complete, sustained relief of medically intractable FHD. The term Vo-complex refers to the combination of the ventralis oralis anterior nucleus (Voa) and ventralis oralis posterior nucleus (Vop) of the thalamus.
Case report.
A 34-year-old right-handed man without a notable medical history experienced gradual onset of writer's cramp of the right hand beginning at age 31. At age 32 he also noted progressively worsening stiffness of the fingers and wrist of his left hand. As the focal injection of botulinum toxin and sequential pharmacologic trials that included clonazepam, baclofen, and etizolam produced unsatisfactory results, they were discontinued.
On admission, his physical and mental condition was normal. Brain MRI and laboratory studies revealed no abnormal findings. The causes of secondary dystonia were excluded as far as possible. There were no neurologic abnormalities except for …
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
