Thalamotomy with focused ultrasound in the treatment of musician’s dystonia

Abstract

Background. Approximately from 0.5 to 8 % professional musicians may suffer from focal dystonia. Stereotactic surgery is option if conservative therapy is failed. Thalamotomy has been reported in limited series in the world literature. Aim. To demonstrate a clinical case of thalamotomy with focused ultrasound in a professional guitarist with focal dystonia of the hand. M ate ri als a nd me t h o d s. A 40‑year‑old patient suffered from spasms of the fingers while playing the guitar since 2009. Patient lost professional skills and changed his activities due to progression and severity of disease. He visited our clinic for surgical treatment, stereotactic ventro‑oral thalamotomy by transcranial focused ultrasound was considered. Results. Thalamotomy provided complete reduction of dystonia without complications. On the 2nd day after the procedure, the patient discharged. In a week mild dysarthria was noticed, which did not affect daily activities and completely regressed within a month. A month later, the patient was able to return to concert performance. The follow‑up period was 6 months with no symptoms of the disease. Conclusion. Successful clinical case of focused ultrasound thalamotomy in patient with musician’s dystonia is presented.