Surgery of involuntary movements, particularly stereotactic surgery: reminiscences.

WHEN WE STARTED using stereotactic surgery in 1953, the existing stereotactic instruments required general anesthesia for fixation of the head. We designed a stereotactic instrument with target screens that could be fixed to the patient's head under local anesthesia. The results of stereotactic surgery for spasmodic torticollis were inconsistent. The active muscles were identified by electromyography and blocked with 1% lidocaine, resulting in marked but temporary improvement. It was decided to use selective peripheral denervation in these cases with very satisfactory results, and it became the only procedure we used for the relief of spasmodic torticollis.