title: Deep brain stimulation of the internal globus pallidus for disabling haloperidol-induced tardive dystonia. Report of two cases.
abstract: OBJECTIVE
  Tardive dystonia (TD) represents a side effect of prolonged intake of neuroleptic drugs. TD can be a disabling movement disorder persisting despite available medical treatment. Deep brain stimulation (DBS) has been reported successful in this condition although the number of treated patients with TD is still limited to small clinical studies or case reports. In this study, we present 2 additional cases of patients after bilateral globus pallidus internus (GPi) stimulation.
  
  
  METHODS
  The formal assessment included the Burke-Fahn-Dystonia Rating Scale (BFMDRS). The preoperative and postoperative functional and motor parts of this scale were compared in each patient. The postoperative assessments were done every 6 months.
  
  
  RESULTS
  Both patients underwent successful bilateral GPi DBS for TD. The postoperative motor score improved by 78% at 24 months in patient 1 and 69% at 12 months in patient 2. There were no surgical or hardware-related complications over follow-up period.
  
  
  CONCLUSIONS
  Our experience indicates that bilateral GPi DBS can be an effective treatment for disabling TD. The response of TD to bilateral GPi DBS is very rapid and occurs within days after the procedure.
authors.affiliation: Neurosurgical Department, Postgraduate Medical Center, Warsaw, Poland. Electronic address: mrsob@op.pl.
authors.forename: Michał
authors.initials: M
authors.lastname: Sobstyl
authors.affiliation: Neurosurgical Department, Postgraduate Medical Center, Warsaw, Poland. Electronic address: zabek@mds.pl.
authors.forename: Mirosław
authors.initials: M
authors.lastname: Ząbek
authors.affiliation: Neurosurgical Department, Bródno Regional Hospital, Warsaw, Poland. Electronic address: mosszbigniew@op.pl.
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Mossakowski
authors.affiliation: Neurosurgical Department, Bródno Regional Hospital, Warsaw, Poland. Electronic address: zaczynskicmc@gmail.com.
authors.forename: Artur
authors.initials: A
authors.lastname: Zaczyński
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000188:drug therapy; D046690:Deep Brain Stimulation / Q000379:methods*; D003866:Depressive Disorder / Q000188:drug therapy; D005917:Globus Pallidus / Q000503:physiopathology*; D006220:Haloperidol / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D000071057:Tardive Dyskinesia / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents; D006220:Haloperidol
keywords: Deep brain stimulation; Globus pallidus; Pallidal stimulation; Tardive dyskinesia; Tardive dystonia