MRI guided stereotactic ventrointermediate thalamotomy for writer's cramp: two cases report and literature review

Abstract

Objective To explore the methods and curative effect of stereotactic surgery for treating writer's cramp (WC). Methods and Results Two patients with writer's cramp (tremor type) underwent MRI guided stereotactic ventrointermediate (Vim) thalamotomy on the left side. The symptoms of one patient disappeared immediately after operation, and the patient could write legibly. The tremor of right upper extremity in another patient was improved significantly. Two patients did not present obvious complications, and the previous symptoms were not found to recur during follow-up period respectively. Conclusions Stereotactic surgery for treatment of writer's cramp has definite therapeutic effect. MRI guided stereotactic technique can effectively avoid the complications of Vim thalamotomy. However, the indications of two methods in surgical treatment [thalamotomy and deep brain stimulation (DBS)] and the respective merits still need further study. DOI: 10.3969/j.issn.1672-6731.2015.10.009

Keywords

• Dystonic disorders
• Stereotaxic techniques
• Ventral thalamic nuclei
• Magnetic resonance imaging