Postoperative 18F-FDG-PET/CT documents efficacy of selective peripheral denervation for treating cervical dystonia
- Department of Neurosurgery, Tokyo Women’s Medical University, Japan.
Isamu Miura, Department of Neurosurgery, Neurological Institute, Tokyo Women’s Medical University, Shinjyuku-ku, Kawada-cho, 8-1, 162-8666. Tokyo, Japan.
DOI:10.25259/SNI_566_2022Copyright: © 2022 Surgical Neurology International This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
How to cite this article: Isamu Miura, Shiro Horisawa, Takakazu Kawamata, Takaomi Taira. Postoperative 18F-FDG-PET/CT documents efficacy of selective peripheral denervation for treating cervical dystonia. 15-Jul-2022;13:301
How to cite this URL: Isamu Miura, Shiro Horisawa, Takakazu Kawamata, Takaomi Taira. Postoperative 18F-FDG-PET/CT documents efficacy of selective peripheral denervation for treating cervical dystonia. 15-Jul-2022;13:301. Available from: https://surgicalneurologyint.com/surgicalint-articles/11722/
Background: Cervical dystonia, characterized by involuntary contraction of the cervical muscles, is the most common form of adult dystonia. We compared the preoperative versus postoperative 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) scans to confirm the efficacy of selective peripheral denervation (SPD) for treating cervical dystonia.
Case Description: A 38-year-old male with the right-sided cervical dystonia underwent a left pallidothalamic tractotomy. However, the involuntary neck movement persisted and correlated with the 18F-FDG-PET/CT imaging that showed persistent FDG uptake in the right obliquus capitis inferior muscle. A subsequent SPD resulted in resolution of the dystonia that correlated with lack of further 18F-FDG-PET/CT uptake in the right obliquus capitis inferior muscle.
Conclusion: The postoperative 18F-FDG-PET/CT documented the efficacy of an SPD in resolving a patient’s cervical dystonia.
Keywords: 18F-FDG-PET/CT, Cervical dystonia, Selective peripheral denervation, SPD
Cervical dystonia, characterized by the involuntary contraction of the cervical muscles, is the most common form of adult dystonia. Preoperatively and postoperatively, dystonic muscles can be identified utilizing 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/ computed tomography (PET/CT).[
A 38-year-old man was diagnosed with dystonia at the age of 37. He was unsuccessfully treated with trihexyphenidyl, clonazepam, and BT injections. He underwent a left pallidothalamic tractotomy but failed to improve over 3 postoperative months. When he was referred for an SPD, his Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) score (range 0–85) was 27. FDG (317 MBq) was injected into the patient at rest. The 18F-FDG-PET/CT imaging showed FDG uptake in the right obliquus capitis inferior muscle [
18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography axial imaging. Preoperative image shows abnormally higher FDG uptake in the right obliquus capitis inferior (arrow) (a). Postoperative image shows the disappearance of FDG uptake in the right obliquus capitis inferior (arrow) (b).
The patient underwent a C1 right hemilaminectomy, with intradural dissection of the C1 and C2 anterior rootles/removal of the dentate ligament [
SPD is an effective treatment operation for cervical dystonia.[
Here, we presented a patient whose cervical dystonia resolved following an SPD as confirmed by a postoperative 18F-FDG PET/CT.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent.
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Conflicts of interest
There are no conflicts of interest.
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