[First experiences in deep brain stimulation for cervical dystonia].
BACKGROUND
Cervical dystonia results in severe disability and cannot be effectively treated with medication. Repeat injections of botulinum toxin into the dystonic neck muscles can relieve the symptoms in most patients. When this treatment fails (mostly due to antibody formation), deep brain stimulation can be considered.


METHODS
We report our experiences with eight patients who were treated with bilateral deep brain stimulation of the globus pallidus interna for cervical dystonia. The mean observation period was 31 months.


RESULTS
Six of eight patients experienced relief from symptoms a few days after the implantation. Improvement of symptoms was a mean of 60% during the 1st year. There were no complications.


CONCLUSIONS
In this and in other studies with small numbers of patients, deep brain stimulation has shown a good effect on cervical dystonia. According to our results, the patients who benefit most are those with no dystonic shoulder involvement and who have a tonic rather than clonic symptomatology. It seems probable that deep brain stimulation will become the therapy of choice for otherwise intractable cervical dystonia.
Bötzel
K
K
Neurologische Klinik der Ludwig-Maximilians-Universität, Klinikum Grosshadern, 81377 München. kboetzel@med.uni-muenchen.de
Steude
U
U
D000328:Adult; D000368:Aged; D046690:Deep Brain Stimulation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D014103:Torticollis / Q000175:diagnosis* / Q000628:therapy*; D016896:Treatment Outcome