Long-Term Assessment of Stereotactic Dentatotomy for Spasticity and Other Disorders

  • J. Siegfried
  • J. C. Verdie
Part of the Acta Neurochirurgica Supplementum book series (NEUROCHIRURGICA, volume 24)


In the 60’s stereotactic electrocoagulation of the dentate nucleus became a promising approach in the neurosurgical treatment of muscular hypertonicity, particularly when spasticity was evident. A relatively satisfactory improvement of spasticity has been reported earlier as a result and the authors were supporting these clinical results in previous publications. A long-term assessment of the results obtained in a large series of patients would permit a better evaluation of the effect of the operation. Analysing 109 stereotactic electrocoagulations of the dentate nucleus on 50 patients mainly in cases of cerebral palsy over a period of more than 10 years (most patients underwent a bilateral dentatotomy), the authors give a more realistic appreciation of the results, which depend on the criteria chosen. In 30% of the cases a clear improvement in the spasticity was obtained, and in 50% of all cases, nursing and rehabilitation were facilitated. The stereotactic dentatotomy never completely cured the spasticity and spectacular results were never observed, but the operation can be performed without complications and an unexpected neurological deficit did not occur. The role of the stereotactic dentatotomy and other neurosurgical methods in the treatment of spasticity has to be evaluated more critically.


Multiple Sclerosis Cerebral Palsy Involuntary Movement Dentate Nucleus Cerebellar Nucleus 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Balasubramaniam, V., Kanaka, T. S., Ramanujam, P. B. (1974), Stereotaxic surgery for cerebral palsy. J. Neurosurg. 40, 577–582.CrossRefGoogle Scholar
  2. 2.
    Cook, A. W., Weinstein, S. P. (1973), Chronic dorsal column stimulation in multiple sclerosis. New York State J. Med. 73, 2868–2872.Google Scholar
  3. 3.
    D’Andrea, F., Ferrari, E., Divitis, E., Mattioli, G. (1966), Effeti immediati e tardivi della coagulazione stereotassica mono e bilaterale del nucleo dentato sulla „dissinergia cerebrale mioclonica“. Min. Neurochir. 10, 375–379.Google Scholar
  4. 4.
    Delmas-Marsalet, P., Bogaert, L. van (1935), Sur un cas de myoclonies rhythmiques continues déterminées par une intervention chirurgicale sur le tronc cérébral. Rev. Neurol. 64, 728–740.Google Scholar
  5. 5.
    Divitis, E., Signorelli, L. D., Cerillo, A. (1972), Stereotaxic surgery for non-parkinsonian dyskinesias. Neurochirurgia 15, 92–95.Google Scholar
  6. 6.
    Fraioli, B., Guidetti, B., La Torre, E. (1974), The stereotaxic dentatotomy in the treatment of spasticity and dyskinetic disorders. J. neurol. Sci. 49–52.Google Scholar
  7. 7.
    Heimburger, R. F. (1967), Dentatectomy in the treatment of dyskinetic disorders. Confin. Neurol. (Basel) 29, 101–106.CrossRefGoogle Scholar
  8. 8.
    Heimburger, R. F. (1969), The role of the cerebellar nuclei in dyskinetic disorders. Confin. Neurol. (Basel) 31, 57–72.CrossRefGoogle Scholar
  9. 9.
    Heimburger, R. F. (1970), The cerebellum and spasticity. Int. J. Neurol. 7, 232–243.PubMedGoogle Scholar
  10. 10.
    Heimburger, R. F. (1970), The role of the cerebellar nuclei in spasticity. Confin. Neurol. (Basel) 32, 105–113.CrossRefGoogle Scholar
  11. 11.
    Heimburger, R. F., Whitlock, C. C. (1965), Stereotaxic destruction of the human dentate nucleus. Confin. Neurol. (Basel) 26, 346–358.Google Scholar
  12. 12.
    Nádvorník, P., Šramka, M., Lisy, L., Svicka, I. (1972), Experiences with dentatotomy. Confin. Neurol. (Basel) 34, 320–324.CrossRefGoogle Scholar
  13. 13.
    Nádvorník, P., Šramka, M. (1973), Transtentorial dentatotomy in “Recent progress in neurological surgery”. Excerpta Medica 293, 19.Google Scholar
  14. 14.
    Nashold, B. S., Slaughter, D. G. (1969), Effects of stimulating and destroying the deep cerebellar regions in man. J. Neurosurg. 31, 172–186.PubMedCrossRefGoogle Scholar
  15. 15.
    Krayenbühl, H., Siegfried, J. (1969), La chirurgie stéréotaxique du noyau dentelé dans le traitement des hyperkinésies et des états spastiques. Neuro-Chirurgie 15, 51–58.PubMedGoogle Scholar
  16. 16.
    Krayenbühl, H., Siegfried, J. (1972), Dentatotomies or thalamotomies in the treatment of hyperkinesia. Confin. Neurol. (Basel) 34, 29–33.CrossRefGoogle Scholar
  17. 17.
    Siegfried, J. (1970), L’apport de la neurochirurgie fonctionelle dans le traitement des infirmes moteurs cérébraux. Rev. Oto-Neuro-Ophtalm. 42, 412–414.Google Scholar
  18. 18.
    Siegfried, J. (1971), Stereotaxic cerebellar surgery. Confin. Neurol. (Basel) 33, 350–360.CrossRefGoogle Scholar
  19. 19.
    Siegfried, J., Ketz, E., Trachtenberg, M. (1972), Stereotactic recording on the depth of the cerebellum. In: Neurophysiology studied in man ( Somjen, ed.). Vol. 1, pp. 366–369. Amsterdam: Excerpta Medica.Google Scholar
  20. 20.
    Siegfried, J. (1972), Stereotactic treatment of hypertonicity. In: Present limits of neurosurgery (Fusek, I., Kunc, 2., eds.). Vol. 1, pp. 549–550. Prague: Avicenum.Google Scholar
  21. 21.
    Siegfried, J. (1974), Methods and results in spasticity and hyperkinesias. In: Recent progress in neurological surgery (Sano, K., Ishii, S., eds.), Vol. 1, pp. 251–255. Amsterdam: Excerpta Medica and New York: Elsevier.Google Scholar
  22. 22.
    Siegfried, J., Esslen, E., Gretener, U., Ketz, E., Perret, E. (1970), Functional anatomy of the dentate nucleus in the light of stereotaxic operations. Confin. Neurol. (Basel) 32, 1–10.CrossRefGoogle Scholar
  23. 23.
    Siegfried, J., Perret, E. (1968), La dentatotomie stéréotaxique: nouvelle méthode de traitement chirurgical des hyperkinésies. Rev. Oto-Neuro-Ophtalm. 40, 341–343.Google Scholar
  24. 24.
    Zervas, N. T. (1970), Paramedial cerebellar nuclear lesions. Confin. Neurol. (Basel) 32, 114–117.CrossRefGoogle Scholar
  25. 25.
    Zervas, N. T., Horner, F. A., Pickren, K. S. (1967), The treatment of dyskinesias by stereotaxic dentatectomy. Confin. Neurol. (Basel) 29, 93–100.CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 1977

Authors and Affiliations

  • J. Siegfried
    • 1
    • 2
  • J. C. Verdie
    • 1
  1. 1.Department of Neurological Surgery, KantonsspitalUniversity of ZürichSwitzerland
  2. 2.Neurochirurgische UniversitätsklinikKantonsspitalZürichSwitzerland

Personalised recommendations