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Millicent Euton

Neurosurgeon: Jonathan R. Jagid, M.D.

At the age of 9, Millicent Euton’s mother began to notice something odd about her daughter’s hand movements. Despite being right-handed, her daughter had begun to use her left hand more and more for routine tasks, including writing. She found this unusual as Millicent had previously met all normal developmental milestones and was the product of a full term pregnancy and normal vaginal delivery with no complications. One year later, additional symptoms surfaced and Millicent was finally diagnosed in 2003 with Generalized Torsion Dystonia having a confirmed deletion mutation in CAG946 of the DYT1 gene.

“I met Millicent in October 2004 when she was referred to me by her pediatric neurologist”, stated Dr. Bruno V. Gallo, Assistant Professor of Neurology and a specialist in Deep Brain Stimulation (DBS) and movement disorders at the University of Miami Miller School of Medicine. “When we met, she was 14 years old and had been confined to a wheelchair unable to walk independently. Although Millicent was intelligent and bright, she was ‘locked’ into her body with involvement of both upper and lower extremities and her axial musculature. She could, with great difficulty, transfer herself from her wheelchair to bed, but could not ambulate.”

Prior to being seen by Dr. Gallo, Ms. Euton had been treated with Carbidopa-Levodopa having some efficacy but the benefit was not long lasting. Later, she required combination therapy with Carbamazepine, Trihexaphenidyl and multiple courses of physical therapy but suffered from medication side effects. While receiving treatment with the Movement Disorders team, Dr. Gallo and the clinical staff held lengthy counseling sessions with the patient and her parents about the medical treatment of dystonia and available surgical approaches, including the use of DBS. At that time, the family decided to explore some additional medical therapies for Millicent as an alternative to the proposed surgical intervention.

The additional medical therapies failed and she was seen in 2008 by Dr. Jonathan Jagid, Assistant Professor of Neurological Surgery and Director of Functional Neurosurgery at the Miller School of Medicine, who recommended proceeding with DBS of the globus pallidus pars interna in the hopes of making a difference in her quality of life. Comprehensive dystonia rating scales were completed in the office in preparation for surgery and that November, she underwent the surgical procedure at Jackson Memorial Hospital.

Advanced 3 Tesla MRI CT fusion technology and intra-operative neurophysiologic microelectrode recordings resulted in accurate electrode targeting and placement. “Few neurosurgical procedures have the ability to alter the function of the brain producing such profound improvements in quality of life” noted Dr. Jagid. Post-operatively, Millicent did well with no complications and the programming of her deep brain stimulators began a month later in December of 2008.

By June of the following year, she was able to cross her legs normally in her wheelchair and transfer herself with greater ease from chair to bed. Dr. Gallo continued with outpatient programming of the device and noted, “by August of 2009, I specifically remember getting a phone call from the patient’s mother telling me that Millicent ‘was walking’ all alone!”

Millicent is now independent with all her activities of daily living and last fall enrolled in art school in Charlotte, North Carolina beginning classes in January 2010. She has done well and is currently enjoying the normal college experience along with her other 19 year old peers.