title: Neurosurgical treatment for dystonia: long-term outcome in a case series of 80 patients.
abstract: BACKGROUND
  In this study, we assessed the outcomes of patients with dystonia who underwent surgery treatment following the same algorithm.
  
  
  METHODS
  Eighty consecutive patients with dystonia were submitted to neurosurgical management by means of intrathecal pump implantation, pallidotomy or deep brain stimulation (GPi or VIM). These patients included 48 patients with primary dystonia and 32 patients with secondary dystonia. Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) was used to access pre- and post-operative outcomes. Patients were followed from 12 to 114 months.
  
  
  RESULTS
  Mean improvement in BFMDRS score among patients with PrD was 87.54% and 42.21% for SeD. Hemidystonic patients in both groups (PrD, SeD) showed a mean improvement in BFMDRS of 71.05% with GPiDBS. Patients with SeD due to previous perinatal insults showed a mean improvement in BFMDRS of 41.9%, with better results in purely dyskinetic patients (mean improvement of 61.2%).
  
  
  CONCLUSIONS
  Use of the proposed algorithm facilitated surgical decision planning, which translated in improved diagnostic rates, earlier interventions, appropriate management plans, and outcomes for both groups (PrD, SeD). Therefore, neuroimaging findings had a positive prognostic significance in the response to treatment in patients with primary dystonia compared with patients with secondary dystonia or distortion of basal ganglia anatomy. However, further studies in this line are warranted.
authors.affiliation: Department of Stereotactic and Functional Neurosurgery, Movement Disorders and Pain Clinic - CIMAD, Carrera 19A No. 82-14, Bogotá, Colombia; Department of Neurosciences, Marly Clinic, Calle 50 No. 9-67, Bogotá, Colombia. Electronic address: jairoespinoza@cimad.net.co.
authors.forename: Jairo Alberto Espinoza
authors.initials: JA
authors.lastname: Martínez
authors.affiliation: Department of Stereotactic and Functional Neurosurgery, HELIOS Klinikum Berlin-Buch Medical Center, Schwanebecker Chaussee 50, 13125 Berlin, Germany; Department of Stereotactic and Functional Neurosurgery, University Medical Center, Breisacher Straße 64, 79106 Freiburg, Germany.
authors.forename: Marcus O
authors.initials: MO
authors.lastname: Pinsker
authors.affiliation: Department of Stereotactic and Functional Neurosurgery, Movement Disorders and Pain Clinic - CIMAD, Carrera 19A No. 82-14, Bogotá, Colombia; Department of Neurosciences, Marly Clinic, Calle 50 No. 9-67, Bogotá, Colombia.
authors.forename: Gabriel J
authors.initials: GJ
authors.lastname: Arango
authors.affiliation: Department of Stereotactic and Functional Neurosurgery, Movement Disorders and Pain Clinic - CIMAD, Carrera 19A No. 82-14, Bogotá, Colombia; Department of Neurosciences, Marly Clinic, Calle 50 No. 9-67, Bogotá, Colombia.
authors.forename: Xiomara
authors.initials: X
authors.lastname: Garcia
authors.affiliation: Department of Stereotactic and Functional Neurosurgery, Movement Disorders and Pain Clinic - CIMAD, Carrera 19A No. 82-14, Bogotá, Colombia; Department of Neurosciences, Marly Clinic, Calle 50 No. 9-67, Bogotá, Colombia.
authors.forename: Andrés Escobar V
authors.initials: AE
authors.lastname: Oscar
authors.affiliation: Department of Stereotactic and Functional Neurosurgery, University Medical Center, Breisacher Straße 64, 79106 Freiburg, Germany.
authors.forename: Luciano
authors.initials: L
authors.lastname: Furlanetti
authors.affiliation: Department of Stereotactic and Functional Neurosurgery, University Medical Center, Breisacher Straße 64, 79106 Freiburg, Germany; Neurosurgery Department. Städtisches Klinikum München, Thalkirchner Straße 48, 80337 München, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Reithmeier
authors.affiliation: Institut des Neurosciences Cellulaires et Intégratives (INCI) CNRS/Université Louis Pasteur de Strasbourg, 5 rue Blaise Pascal, 67084 Strasbourg, France.
authors.forename: Iñigo Alonso Aguirre
authors.initials: IA
authors.lastname: Aranda
authors.affiliation: San Jose Hospital, Neuroradiology Department, Bogotá, Colombia.
authors.forename: Jorge Humberto
authors.initials: JH
authors.lastname: Marin
authors.affiliation: Department of Stereotactic and Functional Neurosurgery, University Medical Center, Breisacher Straße 64, 79106 Freiburg, Germany; Division of Neurosurgery, Department of Neurology, Stereotactic & Functional neurosurgery, School of Medicine, University of Sao Paulo, Brazil. Electronic address: williamomarcontreraslopez@hotmail.com.
authors.forename: William Omar Contreras
authors.initials: WO
authors.lastname: Lopez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D046690:Deep Brain Stimulation / Q000379:methods; D004421:Dystonia / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D053860:Pallidotomy; D011788:Quality of Life; D012720:Severity of Illness Index; D013995:Time; D016896:Treatment Outcome; D055815:Young Adult
keywords: Burke–Fahn–Marsden Dystonia Rating Scale; Deep brain stimulation; Intrathecal baclofen therapy; Primary dystonia; Secondary dystonia