title: Long-term follow-up study of chronic globus pallidus internus stimulation for posttraumatic hemidystonia.
abstract: The authors report the first case of chronic globus pallidus internus (GPi) stimulation for treatment of medically intractable hemidystonia for which long-term follow-up data are available. The patient had developed left-sided low-frequency tremor and hemidystonia after a severe head trauma sustained at 15 years of age. He experienced relief of the tremor but not of the hemidystonia after a thalamotomy was performed in the right hemisphere 3 years postinjury. When the patient was 24 years old, the authors performed a magnetic resonance-guided stereotactic implantation of a monopolar electrode in the right-sided posteroventral GPi. Chronic deep brain stimulation resulted in remarkable improvement of dystonia-associated pain, phasic dystonic movements, and dystonic posture, which was accompanied by functional gain. Postoperative improvement was sustained after 4 years of follow up. Chronic GPi stimulation appears to be a valuable treatment option for posttraumatic dystonia.
authors.affiliation: Department of Neurosurgery, Inselspital, University of Berne, Switzerland.
authors.forename: T J
authors.initials: TJ
authors.lastname: Loher
authors.forename: M G
authors.initials: MG
authors.lastname: Hasdemir
authors.forename: J M
authors.initials: JM
authors.lastname: Burgunder
authors.forename: J K
authors.initials: JK
authors.lastname: Krauss
mesh_terms: D000328:Adult; D020208:Brain Injury, Chronic / Q000503:physiopathology / Q000628:therapy*; D004292:Dominance, Cerebral / Q000502:physiology*; D004421:Dystonia / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D004599:Electric Stimulation Therapy; D005500:Follow-Up Studies; D005917:Globus Pallidus / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D013238:Stereotaxic Techniques; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome