[Long-term efficacy of deep brain stimulation in patients with dystonia].
In patients with primary generalized or segmental dystonia controlled studies have shown that bilateral pallidal deep brain stimulation (DBS) can reduce disability scores by 40 to 60 %. Up to now, the data base on the therapeutic effects of DBS in selected patients with focal dystonia is less extensive. Long-term efficacy of DBS in dystonia has been demonstrated, but reports have focused mainly on patients with primary generalized dystonia so far, with a mean observation period of approximately 5 years. Predictors of a favourable long-term efficacy of DBS in primary generalized dystonia patients are young age at surgery, a shorter duration of the disease, a lower severity of disability, and a posteroventrolateral localization of the DBS electrode within the globus pallidus internus (GPi). Controlled studies are needed to identify also the factors determining the best long-term outcome of non-generalized dystonia patients treated with DBS.
Wolters
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Klinik und Poliklinik für Neurologie, Universität Rostock, Gehlsheimer Strasse 20, Rostock. alexander.wolters@med.unirostock.de
D046690:Deep Brain Stimulation / Q000295:instrumentation; D004185:Disability Evaluation; D004421:Dystonia / Q000628:therapy*; D004567:Electrodes, Implanted; D005917:Globus Pallidus / Q000502:physiology; D006801:Humans; D016896:Treatment Outcome