Chronic deep brain stimulation for segmental dystonia.
Fourteen consecutive patients with segmental dystonia underwent chronic deep brain stimulation (DBS) surgery in the frame of a prospective study protocol. Twelve patients received chronic pallidal stimulation, while 2 patients with prominent dystonic tremor received chronic thalamic ventrointermediate nucleus stimulation. Twelve patients had primary dystonia, and 2 patients secondary dystonia. The Burke-Fahn-Marsden dystonia rating scale (BFM motor) showed a mean relative improvement of 57.3% at the first follow-up (FU1, mean 7 months) and 57.8% at the second follow-up (FU2, mean 16 months). The mean BFM scores were 34.9 +/- 17.7 preoperatively, 14.9 +/- 11.7 at FU1, and 14.8 +/- 10.3 at FU2. Scores of the disability subscale improved by 43% at FU1 and 36% at FU2. Improvement was comparatively less in those patients with secondary dystonia. Dysarthria was a limitation of DBS in 4 patients when using high voltage. Overall, chronic DBS is a very effective treatment option for medically refractory segmental dystonia.
Department of Neurology, Universitätsklinikum Mannheim, Mannheim, Germany.
Johannes C
JC
Woehrle
Christian
C
Blahak
Kety
K
Kekelia
Hans-Holger
HH
Capelle
Hansjoerg
H
Baezner
Eva
E
Grips
Ralf
R
Weigel
Joachim K
JK
Krauss
D000328:Adult; D000368:Aged; D046690:Deep Brain Stimulation / Q000009:adverse effects / Q000379:methods*; D020821:Dystonic Disorders / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008839:Microelectrodes; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D016896:Treatment Outcome