title: Motor outcome of dystonic camptocormia treated with pallidal neurostimulation.
abstract: BACKGROUND
  Deep brain stimulation of the internal pallidum (GPi-DBS) is effective for various types of drug-refractory primary dystonias. Rare clinical forms as dystonic camptocormia may profit but available data are scarce.
  
  
  METHODS
  We here report on a retrospective clinical assessment of three patients with primary dystonic camptocormia treated with GPi-DBS.
  
  
  RESULTS
  All three patients showed marked response to bilateral GPi-DBS within days to weeks after surgery which was preserved in the long-term (38-45 months after implantation: mean improvement 82% as rated on the Burke Fahn Marsden Dystonia Rating Scale, 89% in the subitem "trunk"). Two patients developed mild stimulation induced speech problems (stuttering or dysarthria) which resolved with reprogramming or were acceptable in return for the control of dystonic symptoms.
  
  
  CONCLUSIONS
  The diagnosis and treatment of camptocormia will continue to require expert knowledge in movement and neuromuscular disorders, but DBS may expand treatment options in this difficult patient population.
authors.affiliation: Department of Neurology, University Hospital Schleswig-Holstein, Kiel, Germany; Department of Neurology, Julius-Maximilians-University, Würzburg, Germany.
authors.forename: René
authors.initials: R
authors.lastname: Reese
authors.affiliation: Department of Neurology, University Hospital Schleswig-Holstein, Kiel, Germany.
authors.forename: Karina
authors.initials: K
authors.lastname: Knudsen
authors.affiliation: Department of Neurosurgery, University Hospital Schleswig-Holstein, Kiel, Germany.
authors.forename: Daniela
authors.initials: D
authors.lastname: Falk
authors.affiliation: Department of Neurosurgery, University Hospital Schleswig-Holstein, Kiel, Germany.
authors.forename: H Maximilian
authors.initials: HM
authors.lastname: Mehdorn
authors.affiliation: Department of Neurology, University Hospital Schleswig-Holstein, Kiel, Germany. Electronic address: g.deuschl@neurologie.uni-kiel.de.
authors.forename: Günther
authors.initials: G
authors.lastname: Deuschl
authors.affiliation: Department of Neurology, University Hospital Schleswig-Holstein, Kiel, Germany; Department of Neurology, Julius-Maximilians-University, Würzburg, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Volkmann
mesh_terms: D046690:Deep Brain Stimulation / Q000379:methods*; D020821:Dystonic Disorders / Q000628:therapy*; D004567:Electrodes, Implanted; D005260:Female; D005917:Globus Pallidus / Q000502:physiology / Q000601:surgery; D006801:Humans; D008297:Male; D009134:Muscular Atrophy, Spinal / Q000628:therapy*; D012189:Retrospective Studies; D013121:Spinal Curvatures / Q000628:therapy*; D016896:Treatment Outcome
keywords: Camptocormia; Deep brain stimulation; Dystonia; Globus pallidus internus