Immediate recovery of neurological function in response to deep brain stimulation of the globus pallidus internus in a patient with idiopathic camptocormia

Abstract

Camptocormia is a major disabling abnormality characterized by severe forward flexion of the thoracolumbar spine. We report here on the effectiveness of deep brain stimulation (DBS) for the management of a case of untreatable idiopathic camptocormia. The patient, a 51-year-old male, with an 11-year-long history of radicular pain. Camptocormia symptomatology initiated 4 years ago. Preoperative muscle electrodiagnostic testing was within normal limits. Myopathy was ruled out. In the standing position myokymic discharges were recorded. Under local anesthesia and stereotactic control, electrodes for DBS were placed bilaterally in the globus pallidus internus. Patient's symptoms disappeared immediately following DBS. This response cannot be attributed to the surgical procedure itself. When stimulators were turned “off” accidentally, the patient returned immediately to his pre-surgery condition. Erect posture and walking were restored when stimulators were back “on”.

Keywords

• Bent spine syndrome
• Deep brain stimulation
• Functional neurosurgery
• Globus pallidus