title: Long-term benefit sustained after bilateral pallidal deep brain stimulation in patients with refractory tardive dystonia.
abstract: OBJECTIVE
  Tardive dystonia (TD) can be a highly disabling, permanent condition related to the use of dopamine-receptor-blocking medications. Our aim was to evaluate the long-term effect of bilateral pallidal deep brain stimulation (DBS) for TD.
  
  
  METHODS
  Five consecutive patients with disabling TD who underwent stereotactic placement of bilateral globus pallidus internus DBS leads were included. All patients had a history of mood disorder or schizophrenia previously treated with neuroleptic medication, with a mean duration of motor symptoms of 10.2 years. Dystonia severity was measured using the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) movement score by a blinded neurologist reviewing pre- and postoperative videotaped examinations.
  
  
  RESULTS
  The mean baseline movement BFMDRS score was 49.7 (range 20-88). Overall, we observed a mean reduction of 62% in the BFMDRS movement score within the first year after surgery. Persistent improvement in dystonia (71%) was seen at the last follow-up ranging from 2 to 8 years after surgery.
  
  
  CONCLUSIONS
  Our experience suggests that pallidal DBS can be an effective therapy with long-term benefits for patients with TD.
authors.affiliation: Department of Neurological Surgery, University of California, San Francisco, CA 94143, USA. ChangEd@neurosurg.ucsf.edu
authors.forename: Edward F
authors.initials: EF
authors.lastname: Chang
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Schrock
authors.forename: Philip A
authors.initials: PA
authors.lastname: Starr
authors.forename: Jill L
authors.initials: JL
authors.lastname: Ostrem
mesh_terms: D000328:Adult; D046690:Deep Brain Stimulation; D018492:Dopamine Antagonists / Q000009:adverse effects*; D004409:Dyskinesia, Drug-Induced / Q000628:therapy*; D004567:Electrodes, Implanted; D005260:Female; D005917:Globus Pallidus / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000188:drug therapy; D012189:Retrospective Studies; D012559:Schizophrenia / Q000188:drug therapy; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D018492:Dopamine Antagonists