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Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1993 Oct;56(10):1113–1118. doi: 10.1136/jnnp.56.10.1113

Evaluation of the effect of treatment on movement disorders in astrocytomas of the basal ganglia and the thalamus.

J K Krauss 1, D F Braus 1, M Mohadjer 1, F Nobbe 1, F Mundinger 1
PMCID: PMC1015242  PMID: 8410011

Abstract

Twenty patients with movement disorders associated with astrocytomas (grade I-IV according to the WHO tumour classification) of the basal ganglia and the thalamus were evaluated for the effects of treatment. Five patients had more than one movement disorder when the histological diagnosis was verified by stereotactic biopsy. Twelve had tremors, eight hemidystonia, three hemichorea, and one hemichorea/ballismus, and myoclonus respectively. Ten patients died during the follow up period, and for the surviving patients follow up periods ranged from 6-21 years. The movement disorders changed over long periods of time related to therapeutic interventions. CSF shunt operations and percutaneous radiotherapy had no definite effect on the movement disorders. There was a moderate response to medical treatment in a few patients. Stereotactic aspiration of tumour cysts had a marked influence on the movement disorder in two patients, and functional stereotactic surgery abolished tumour induced tremor in one. Interstitial radiotherapy was performed in fifteen patients for treatment of the underlying neoplasm and resulted in different and variable alterations of the movement disorders. These differences may be explained by complex interactions involving structures affected primarily by the tumour, as well as by secondary functional lesions of adjacent structures.

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Selected References

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  1. ARSENI C., NASH F., SAMITCA D. C. Extra-pyramidal syndromes with intracranial tumour. Psychiatr Neurol (Basel) 1959 Apr;137(4):230–244. doi: 10.1159/000134243. [DOI] [PubMed] [Google Scholar]
  2. Bernstein M., Hoffman H. J., Halliday W. C., Hendrick E. B., Humphreys R. P. Thalamic tumors in children. Long-term follow-up and treatment guidelines. J Neurosurg. 1984 Oct;61(4):649–656. doi: 10.3171/jns.1984.61.4.0649. [DOI] [PubMed] [Google Scholar]
  3. Birg W., Mundinger F. Computer calculations of target parameters for a stereotactic apparatus. Acta Neurochir (Wien) 1973;29(1):123–129. doi: 10.1007/BF01414622. [DOI] [PubMed] [Google Scholar]
  4. CHOROBSKI J. Involuntary movements in patients with intracranial tumors. Their occurrence and possible pathogenesis. Arch Neurol. 1962 Jan;6:27–42. doi: 10.1001/archneur.1962.00450190029005. [DOI] [PubMed] [Google Scholar]
  5. Cheek W. R., Taveras J. M. Thalamic tumors. J Neurosurg. 1966 Feb;24(2):505–513. doi: 10.3171/jns.1966.24.2.0505. [DOI] [PubMed] [Google Scholar]
  6. Groothuis D. R., Wright D. C., Ostertag C. B. The effect of 125I interstitial radiotherapy on blood-brain barrier function in normal canine brain. J Neurosurg. 1987 Dec;67(6):895–902. doi: 10.3171/jns.1987.67.6.0895. [DOI] [PubMed] [Google Scholar]
  7. Hirai T., Miyazaki M., Nakajima H., Shibazaki T., Ohye C. The correlation between tremor characteristics and the predicted volume of effective lesions in stereotaxic nucleus ventralis intermedius thalamotomy. Brain. 1983 Dec;106(Pt 4):1001–1018. doi: 10.1093/brain/106.4.1001. [DOI] [PubMed] [Google Scholar]
  8. Kelly P. J. Stereotactic biopsy and resection of thalamic astrocytomas. Neurosurgery. 1989 Aug;25(2):185–195. [PubMed] [Google Scholar]
  9. Krauss J. K., Mohadjer M., Braus D. F., Wakhloo A. K., Nobbe F., Mundinger F. Dystonia following head trauma: a report of nine patients and review of the literature. Mov Disord. 1992;7(3):263–272. doi: 10.1002/mds.870070313. [DOI] [PubMed] [Google Scholar]
  10. Krauss J. K., Mohadjer M., Nobbe F., Scheremet R. Hemidystonia due to a contralateral parieto-occipital metastasis: disappearance after removal of the mass lesion. Neurology. 1991 Sep;41(9):1519–1520. doi: 10.1212/wnl.41.9.1519. [DOI] [PubMed] [Google Scholar]
  11. Krauss J. K., Nobbe F., Wakhloo A. K., Mohadjer M., Vach W., Mundinger F. Movement disorders in astrocytomas of the basal ganglia and the thalamus. J Neurol Neurosurg Psychiatry. 1992 Dec;55(12):1162–1167. doi: 10.1136/jnnp.55.12.1162. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Kulali A., Tuğtekin M., Utkür Y., Erkurt S. Ipsilateral hemi-parkinsonism secondary to an astrocytoma. J Neurol Neurosurg Psychiatry. 1991 Jul;54(7):653–653. doi: 10.1136/jnnp.54.7.653. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. MILLICHAP J. G., MILLER R. H., BACKUS R. E. Intracranial tumors in childhood. Manifestation as chorea and other involuntary movements. JAMA. 1962 Feb 24;179:589–593. doi: 10.1001/jama.1962.03050080001001. [DOI] [PubMed] [Google Scholar]
  14. Maeda T., Kondo T., Ohye C., Narabayashi H. Physiologically controlled VIM thalamotomy for red nucleus syndrome: report of two cases [proceedings]. Appl Neurophysiol. 1979;42(5):310–311. [PubMed] [Google Scholar]
  15. Marsden C. D., Obeso J. A., Zarranz J. J., Lang A. E. The anatomical basis of symptomatic hemidystonia. Brain. 1985 Jun;108(Pt 2):463–483. doi: 10.1093/brain/108.2.463. [DOI] [PubMed] [Google Scholar]
  16. McGirr S. J., Kelly P. J., Scheithauer B. W. Stereotactic resection of juvenile pilocytic astrocytomas of the thalamus and basal ganglia. Neurosurgery. 1987 Mar;20(3):447–452. doi: 10.1227/00006123-198703000-00016. [DOI] [PubMed] [Google Scholar]
  17. McKISSOCK W., PAINE K. W. Primary tumours of the thalamus. Brain. 1958 Mar;81(1):41–63. doi: 10.1093/brain/81.1.41. [DOI] [PubMed] [Google Scholar]
  18. Mundinger F., Braus D. F., Krauss J. K., Birg W. Long-term outcome of 89 low-grade brain-stem gliomas after interstitial radiation therapy. J Neurosurg. 1991 Nov;75(5):740–746. doi: 10.3171/jns.1991.75.5.0740. [DOI] [PubMed] [Google Scholar]
  19. Mundinger F. CT stereotactic biopsy for optimizing the therapy of intracranial processes. Acta Neurochir Suppl (Wien) 1985;35:70–74. doi: 10.1007/978-3-7091-8813-2_10. [DOI] [PubMed] [Google Scholar]
  20. Mundinger F., Sauerwein K. 'Gammamed', ein gerät zur bestrahlung von hirngeschwülsten mit radioisotopen. Acta Radiol Ther Phys Biol. 1966;5:48–52. [PubMed] [Google Scholar]
  21. Narbona J., Obeso J. A., Tuñon T., Martinez-Lage J. M., Marsden C. D. Hemi-dystonia secondary to localised basal ganglia tumour. J Neurol Neurosurg Psychiatry. 1984 Jul;47(7):704–709. doi: 10.1136/jnnp.47.7.704. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Nittner K. Doppelseitige einzeitige stereotaktische Hirnoperation nach Hirntumoroperation. Nervenarzt. 1965 Sep;36(9):394–397. [PubMed] [Google Scholar]
  23. Ostertag C. B., Weigel K., Warnke P., Lombeck G., Kleihues P. Sequential morphological changes in the dog brain after interstitial iodine- 125 irradiation. Neurosurgery. 1983 Nov;13(5):523–528. doi: 10.1227/00006123-198311000-00007. [DOI] [PubMed] [Google Scholar]
  24. Pettigrew L. C., Jankovic J. Hemidystonia: a report of 22 patients and a review of the literature. J Neurol Neurosurg Psychiatry. 1985 Jul;48(7):650–657. doi: 10.1136/jnnp.48.7.650. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. ROTH R. L., BEBIN J. Cerebral hemispheric tumors and extrapyramidal signs and symptoms. Neurology. 1958 Apr;8(4):277–284. doi: 10.1212/wnl.8.4.277. [DOI] [PubMed] [Google Scholar]
  26. SCIARRA D., SPROFKIN B. E. Symptoms and signs referable to the basal ganglia in brain tumor. AMA Arch Neurol Psychiatry. 1953 Apr;69(4):450–461. doi: 10.1001/archneurpsyc.1953.02320280038004. [DOI] [PubMed] [Google Scholar]
  27. Sypert G. W., Leffman H., Ojemann G. A. Occult normal pressure hydrocephalus manifested by parkinsonism-dementia complex. Neurology. 1973 Mar;23(3):234–238. doi: 10.1212/wnl.23.3.234. [DOI] [PubMed] [Google Scholar]

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