title: Bilateral pallidal stimulation for cervical dystonia. An optimal paradigm from our experiences.
abstract: We sought to identify optimal paradigms of bilateral globus pallidus internus (GPi) stimulation in 3 subsequent patients with severe cervical dystonia. At low frequency stimulation (50-60 Hz) with wide pulse width (500 micros) and high amplitude (4.5-8.0 V), we observed immediate and consistent improvement of dystonia and dystonia-associated pain. Stimulation of the posteroventral portion of the GPi led to pronounced alleviation of dystonia; stimulation of the anterodorsal portion or at the dorsal border of the GPi resulted in significant worsening of symptoms. The therapeutic benefit obtained by using the optimal stimulation parameters continues and has lasted for at least 1 year in each patient.
authors.affiliation: Department of Neurosurgery, Kumamoto University Medical School, Kumamoto, Japan. sgoto@kaiju.medic.kumamoto-u.ac.jp
authors.forename: Satoshi
authors.initials: S
authors.lastname: Goto
authors.forename: Shuji
authors.initials: S
authors.lastname: Mita
authors.forename: Yukitaka
authors.initials: Y
authors.lastname: Ushio
mesh_terms: D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D007839:Functional Laterality; D005917:Globus Pallidus / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013238:Stereotaxic Techniques; D014103:Torticollis / Q000601:surgery* / Q000628:therapy*