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PubMed1994

Chronic electrical stimulation of the VL-VPL complex and of the pallidum in the treatment of movement disorders: personal experience since 1982.

Since 1982, we have been able to control involuntary movements associated with deaf-ferentation by means of chronic electrical stimulation of the thalamic sensory nucleus through implanted programmable neuropacemakers. Since 1987, we have been using the same system with electrodes chronically implanted in the VL for treating selected cases of tremor due to Parkinson's disease, multiple sclerosis and in cases of essential tremor. In our series of 60 patients, suppression of tremor was achieved in almost all cases; however, due to dysarthria in 30% of the cases (cases after previous thalamotomy in the other side or with bilateral stimulation), the amplitude of stimulation was corrected and thus some tremor was still observed. The rigidity of parkinsonism was in all cases improved. One case of hemiballism was perfectly controlled with the same technique. Finally, 3 cases of Parkinson's disease with severe hypokinesia, speech and gait disturbances, and on-off phenomenon have been globally improved by a bilateral chronic stimulation of the pallidum.

Aged↗
PubMed1986

Eyelid movement disorders and motor impersistence in acute hemisphere disease.

The aim of this study was to evaluate, in an acutely brain-damaged population, the occurrence of motor impersistence and its relation to the side of lesion. All the patients hospitalized in a 10-month period for a stroke involving one hemisphere and able to cooperate were given, in the early days of illness, a motor impersistence battery requiring the maintenance of a position of eyelids, gaze, mouth, and limbs for 10 seconds. A control group of 50 patients without brain damage provided the basis for evaluating pathologic performance. Failure to keep eyes closed was the most common manifestation of motor impersistence. It sometimes affected the contralateral eye alone, lasted in a few patients for 3 months, and was significantly more frequent after right than left brain damage. Three right brain-damaged (RBD) patients showed a complete inability to initiate lid closure, and one RBD patient a complete inability to initiate lid opening. Impersistence in other somatic areas was more rare.

Acute Disease↗