title: [Severe treatment-resistant tardive dystonia: is deep brain stimulation a treatment option].
abstract: BACKGROUND
  Severe tardive dyskinesia or dystonia (TD) are side-effects of dopamine-blocking agents, most of which are antipsychotics. A small subgroup of patients develop a severe debilitating treatment-resistant form of TD.
  
  
  OBJECTIVE
  To assess the effects and side-effects of deep brain stimulation (DBS) in this subgroup of TD patients.
  
  
  METHODS
  We searched PubMed and Embase using the search terms 'tardive' and 'deep brain stimulation'. We found 19 articles containing data referring to 52 patients. Using the Burke Fahn Marsden Dystonia Rating Scale (BFMDRS), the Abnormal Involuntary Movement Scale (AIMS) and the Extrapyramidal Symptoms Rating Scale (ESRS) we calculated the average improvement in the patients' condition.
  
  
  RESULTS
  On all the scales the improvement was statistically significant (p < 0.00001), the average improvement being 67% to 78%. In only 4% of the patients was there a deterioration in the psychiatric disorder.
  
  
  CONCLUSIONS
  DBS seems to be an effective treatment for treatment-resistant TD and the side-effects seem to be limited. However, the evidence is limited because our conclusion is based on case-reports and on small-scale trials without randomisation or blinding.
authors: C L
authors: CL
authors: Mentzel
authors: D E
authors: DE
authors: Tenback
authors: M A J
authors: MA
authors: Tijssen
authors: P N
authors: PN
authors: van Harten
mesh_terms: D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D046690:Deep Brain Stimulation / Q000009:adverse effects; D006801:Humans; D009069:Movement Disorders / Q000209:etiology* / Q000628:therapy*; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents