[Dystonia].

Dystonia is a movement disorder characterized by sustained or intermittent muscle contractions causing abnormal, often repetitive, movements or postures. Currently, dystonia is defined as a network disorder involving the basal ganglia, cerebellum, thalamus, and sensorimotor cortex. Considering that it is refractory to medical therapy, functional neurosurgery is indispensable in the treatment strategy for dystonia.

Hemichorea induced by a sphenoid ridge meningioma.

Background: Movement disorders are rare in brain tumors. We describe a 45-year-old woman with hemichorea, a concomitant contralateral sphenoid ridge meningioma.

Case Description: The meningioma enlarged as her hemichorea worsened, and after meningioma resection, the hemichorea gradually subsided.

Surgical management of adverse events associated with deep brain stimulation: A single-center experience.

Objectives: Deep brain stimulation is widely used to treat movement disorders and selected neuropsychiatric disorders. Despite the fact, the surgical methods vary among centers. In this study, we aimed to evaluate our own surgical complications and how we performed surgical troubleshooting.

Predictors of Outcomes After Focused Ultrasound Thalamotomy.

Background: Magnetic resonance-guided focused ultrasound thalamotomy (FUS-T) is an emerging treatment for essential tremor (ET).

Objective: To determine the predictors of outcomes after FUS-T.

Methods: Two treatment groups were analyzed: 75 ET patients enrolled in the pivotal trial, between 2013 and 2015; and 114 patients enrolled in the postpivotal trials, between 2015 and 2016.

Combining quantitative susceptibility mapping to the morphometric index in differentiating between progressive supranuclear palsy and Parkinson's disease.

Purpose: To determine whether the susceptibility value in the deep gray matter obtained by quantitative susceptibility mapping (QSM) provides additive value to the morphometric index for differentiating progressive supranuclear palsy (PSP) from Parkinson's disease (PD).

Materials And Methods: PSP- (n = 8) and PD patients (n = 18) and 18 age-matched healthy controls who underwent QSM and 3D magnetization-prepared rapid gradient echo (MPRAGE) sequences. The mean susceptibility values (MSVs) of the deep gray matter structures on QSM- and areas of the midbrain (morphometric index, MI) on 3D MPRAGE images were measured by two neuroradiologists.

Cost-minimisation model of magnetic resonance-guided focussed ultrasound therapy compared to unilateral deep brain stimulation for essential tremor treatment in Japan.

Objective: To investigate the cost differences between magnetic resonance-guided focussed ultrasound (MRgFUS) and unilateral deep brain stimulation (DBS) for the treatment of medication-refractory essential tremor (ET) in Japan using a cost-minimisation model.

Methods: A cost-minimisation model estimated total costs for MRgFUS and unilateral DBS by summing the pre-procedure, procedure, and post-procedure costs over a 12-month time horizon, using data from published sources and expert clinical opinion. The model base case considered medical costs from fee-for-service tariffs.

Impact of skull density ratio on efficacy and safety of magnetic resonance-guided focused ultrasound treatment of essential tremor.

Objective: Skull density ratio (SDR) assesses the transparency of the skull to ultrasound. Magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy in essential tremor (ET) patients with a lower SDR may be less effective, and the risk for complications may be increased. To address these questions, the authors analyzed clinical outcomes of MRgFUS thalamotomy based on SDRs.

Is hemifacial spasm affected by changes in the heart rate? A study using heart rate variability analysis.

Objective: Hemifacial spasm (HFS) is caused by arterial conflict at the root exit zone of the facial nerve. As the offending artery is pulsatile in nature, this study investigated the association of heart rate fluctuation with HFS.

Methods: Twenty-four preoperative patients underwent simultaneous recordings of facial electromyogram and electrocardiogram overnight.

Neurological adverse event profile of magnetic resonance imaging-guided focused ultrasound thalamotomy for essential tremor.

Background: Magnetic resonance imaging-guided focused ultrasound thalamotomy is approved by the U.S. Food and Drug Administration for treatment of essential tremor.

Clinical significance of polyglutamylation in primary central nervous system lymphoma.

The therapeutic response to high-dose methotrexate (HD-MTX) therapy for primary central nervous system lymphoma (PCNSL) varies. Polyglutamylation is a reversible protein modification with a high occurrence rate in tumor cells. MTX incorporated into cells is polyglutamylated and strongly binds to dihydrofolate reductase without competitive inhibition by leucovorin (LV).

Pregabalin as a salvage preoperative treatment for refractory trigeminal neuralgia.

Only few studies have investigated the effectiveness of pregabalin (PGB) treatment for trigeminal neuralgia (TN). We aimed to retrospectively analyze the effectiveness of PGB treatment in refractory TN as a salvage treatment preceding surgery. Of 61 patients with TN refractory to prior treatment with carbamazepine (CBZ), we enrolled 33 patients in our study who agreed to receive PGB before they underwent surgery.

Improvement of visual field defects after focal resection for occipital lobe epilepsy: case report.

Improvement of visual field defects after surgical treatment for occipital lobe epilepsy is rare. Here, the authors report on a 24-year-old man with a 15-year history of refractory epilepsy that developed after he had undergone an occipital craniotomy to remove a cerebellar astrocytoma at the age of 4. His seizures started with an elementary visual aura, followed by secondary generalized tonic-clonic convulsion.

Flatness of the infratentorial space associated with hemifacial spasm.

Background: Whether a difference in morphology of the infratentorial space is associated with hemifacial spasm is not well understood. The aim of this study was to analyze the three-dimensional conformation of the infratentorial space and evaluate any possible contribution of morphological characteristics to the development of neurovascular compression leading to hemifacial spasm.

Methods: We enrolled 25 patients with hemifacial spasm and matched them by age and sex to controls.

Pallidal stimulation for medically intractable blepharospasm.

Deep brain stimulation (DBS) of the globus pallidus internus (GPi) is an established procedure to improve generalised, segmental craniofacial dystonia. However, no studies have addressed the applicability of DBS for blepharospasm as a focal craniofacial dystonia. A 52-year-old man developed medically intractable involuntary eye closure.

Subthalamic nucleus stimulation improves Parkinson's disease-associated camptocormia in parallel to its preoperative levodopa responsiveness.

Objective: The aim of this work was to identify factors predictive of postoperative improvement of camptocormia in patients with Parkinson's disease (PD) treated by subthalamic nucleus (STN) stimulation.

Background: Camptocormia, one of the most disabling features of PD, often responds poorly to medical therapies. The reported effects of deep brain stimulation on PD-associated camptocormia vary, and preoperative characteristics affecting the surgical outcome remain unclear.

An in vivo morphometry study on the standard transsylvian trajectory for mesial temporal lobe epilepsy surgery.

A safe and appropriate surgical approach to the medial temporal structure is a prerequisite to perform surgeries for temporal lobe epilepsy. We used in vivo morphometry to identify the standard direction for entry into the inferior horn of the lateral ventricle via the Sylvian fissure: an important initial step in performing transsylvian selective amygdalohippocampectomy. 3D magnetic resonance images obtained from 28 patients without intra-parenchymal lesions were re-oriented to demonstrate all points in the Talairach space of the brain.

Olfactory auras caused by a very focal isolated epileptic network in the amygdala.

Epileptic olfactory auras manifesting as simple partial seizures are rare. We report a patient who presented with olfactory auras after hemorrhage from a cavernous angioma in the left mesial temporal region. His olfactory auras persisted 12 years after two surgeries for a cavernous angioma.

Thalamic stimulation alleviates levodopa-resistant rigidity in a patient with non-Parkinson's disease parkinsonian syndrome.

Deep brain stimulation (DBS) to the thalamic ventrointermediate nucleus (Vim) is a useful treatment in patients with tremor-dominant Parkinson's disease (PD). Efficacy to alleviate rigidity remains controversial. We report a 65-year-old right-handed man with persistent severe rigidity and bradykinesia on the right side despite daily administration of levodopa/carbidopa (600/60mg).

Seizures as a presenting symptom in neurosurgical patients: a retrospective single-institution analysis.

Background: In patients with brain lesions, the appropriate management of epileptic seizures is important because recurrent seizures have a negative effect on the clinical course and quality of life. Acute symptomatic seizures are known to be one of the risk factors to develop epilepsy that cause recurrent unprovoked seizures in the later stage. To obtain background information, we performed a retrospective study in which we investigated the incidence of seizures as one of the presenting symptoms in neurosurgical patients admitted to our department during the past 43 years.

Usefulness of the coherence entrainment test for deep brain stimulation for a patient with atypical tremor.

A 40-year-old man with an anxiety disorder developed sudden-onset right-hand tremor after a fixation wire for a tibial bone fracture was removed. He manifested a resting and action tremor with an irregular pattern. A coherence entrainment test (CET) revealed that the peak power spectral frequency of the right finger tremor was not entrained by simultaneous voluntary left finger tapping, which indicated a non-psychogenic origin.

Higher incidence of epilepsy in meningiomas located on the premotor cortex: a voxel-wise statistical analysis.

Background: A substantial number of patients with brain tumors develop recurrent seizures, known as tumor-associated epilepsy. It is important to identify specific subgroups of brain tumor patients with higher incidences of epilepsy because a meta-analysis failed to certify the effectiveness of prophylactic anti-epileptic drugs (AEDs) to abort tumor-associated epilepsy as a whole.

Methods: To investigate the relationship between tumor location and incidence of epilepsy, we performed voxel-wise comparison between 3D MRI scans obtained from patients with meningioma-associated epilepsy and those from control patients using spatial normalization techniques on neuroimaging data.

Long disease duration interferes with therapeutic effect of globus pallidus internus pallidal stimulation in primary cervical dystonia.

Objectives: We retrospectively investigated the correlation between disease duration and the therapeutic effect of globus pallidus internus (GPi) stimulation in patients with primary cervical dystonia (CD).

Materials And Methods: Eight patients with CD unresponsive to medical treatments underwent bilateral GPi deep brain stimulation (DBS). They were followed for 63.