摘要目的:探讨双侧苍白球内侧部脑深部电刺激术(GPi-DBS)治疗原发性Meige综合征的临床疗效与安全性。方法:回顾性分析2018年10月至2019年1月北京大学人民医院神经外科采用双侧GPi-DBS治疗的15例原发性Meige综合征患者的临床资料。所有患者均于术后1个月开机，初始刺激脉冲参数为：频率160 Hz，脉宽90 μs，选择恒压刺激，最后选择治疗阈值低而不良反应阈值高的触点作为刺激触点。术后3、6、12个月，对患者行门诊随访，根据其临床症状转归及不良反应出现情况进行刺激参数调整，同时对所有患者行Burke-Fahn-Marsden肌张力障碍量表(BFMDRS)评分，以评估患者的运动功能改善情况。结果:15例患者的手术均成功。术后复查头颅CT结果显示，所有患者的电极均植入双侧GPi。3例患者出现头部沉重感，1例出现言语不清，经调整刺激参数及电极触点后症状均得到缓解或消失。15例患者的随访时间为(7.0±3.8)个月(3～12个月)。15例患者的运动功能均明显改善，总改善比例为13/15。随着治疗时间延长，BFMDRS中眼部和口-下颌评分及BFMDRS总分均呈降低的趋势(均 P<0.05)。术后3、6、12个月BFMDRS评分中，眼部、口-下颌、说话和吞咽以及颈部的评分均较术前明显降低(均 P<0.05)。至末次随访，眼部、口-下颌、说话和吞咽功能以及颈部症状的改善比例分别为12/14 、8/11、4/7、2/4。 结论:双侧GPi-DBS治疗原发性Meige综合征可明显改善患者的运动症状，不良反应少；且随治疗时间延长，眼部和口-下颌症状有逐渐改善的趋势。

abstractsObjective:To assess the clinical efficacy and safety of bilateral deep brain stimulation of globus pallidus internus (GPi-DBS) in idiopathic Meige syndrome (MS).Methods:A retrospective study was conducted on the clinical data of 15 patients with idiopathic MS undergoing bilateral GPi-DBS at Neurosurgery Department of Peking University People′s Hospital from October 2018 to January 2019. DBS device was turned on at 1 month after operation for all patients. The initial stimulation parameters were 160 Hz, 90 μs and constant voltage. And the contact with low treatment threshold and high adverse reaction threshold was selected. At 3, 6 and 12 months after operation, the patients were followed up regularly, and the stimulation parameters were adjusted according to the clinical symptoms and adverse events. Meanwhile, the Burke-Fahn-Marsden dystonia rating scale (BFMDRS) was used to evaluate the symptomatic improvement.Results:All operations were successful and postoperative CT scan showed that all the electrodes were implanted into bilateral GPi. After the operation, there were 3 cases of head heaviness and 1 case of slurred speech. After adjustment of the stimulation parameters and electrode contacts, the symptoms were relieved or disappeared. The mean follow-up time was 7.0±3.8 months (3-12 months). The motor function of 15 patients were improved significantly and the total improvement ratio was 13/15. At 3, 6 and 12 months after operation, the BFMDRS scores of eyes, mouth, speaking and swallowing and neck were significantly lower than those before operation (all P < 0.05). With the extension of treatment time, both the subscores in eyes and mouth and the total BFMDRS scores tended to decrease (all P<0.05). At the last follow-up, the improvement ratios for eye, mouth, speaking and swallowing and neck were 12/14, 8/11, 4/7 and 2/4 respectively. Conclusion:Bilateral GPI-DBS treatment of primary Meige syndrome could significantly improve the patients motor symptoms, with fewer adverse reactions. With the extension of treatment time, eye and mouth symptoms showed a trend of gradual improvement.