A prospective blinded evaluation of deep brain stimulation for the treatment of secondary dystonia and primary torticollis syndromes

Abstract

Global subjective gains and notable objective improvement were observed in 11 of 13 patients. Although the benefits were variable and not fully predictable, they were of sufficient magnitude to justify offering the procedure when medications and botulinum toxin injections have failed.

Dystonia and DBS: The Jury Arrives

“…There are reports of DBS in postanoxic dystonia, postencephalitic dystonia, and posttraumatic dystonia (Eltahawy et al, 2004;Pretto et al, 2008;Katsakiori et al, 2009;Zhang et al, 2006;Krause et al, 2004;Ghika et al, 2002). Improvements in dystonia in Lesch-Nyhan syndrome (Cif et al, 2007;Pralong et al, 2005) and GM1 gangliosidosis (Roze et al, 2006) also have been reported.…”

“…Many case reports and several studies indicate that bilateral GPi DBS is an effective treatment for cervical dystonia (Jeong et al, 2009;Kiss et al, 2007;Kupsch et al, 2006;Pretto et al, 2008). Two long-term follow-up studies showed 67% and 55% improvement in Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) severity scores at 38 and 32 months after surgery, respectively (Cacciola et al, 2010;Hung et al, 2007).…”

“…Some patients had favorable outcomes but others experienced no or only minimal improvement (Alterman and Tagliati, 2007;Pretto et al, 2008;Zorzi et al, 2005). This variability in response is most likely due to the heterogeneity of this condition.…”

What parents think and feel about deep brain stimulation in paediatric secondary dystonia including cerebral palsy: A qualitative study of parental decision-making

“…Although pharmacological management is commonly ineffective in generalised and multifocal dystonia 7,8,9 and is often accompanied by unwanted and adverse side effects 10 . There has been increased focus on emergent neurosurgical interventions for the management of dystonia, and childhood dystonia is now being routinely managed with Deep Brain Stimulation (DBS), a reversible 'non-lesioning' neurosurgical treatment 7 but usually only after demonstrating that dystonia has proven refractory to accepted pharmacological management options 7 .…”

Use of Pallidal Deep Brain Stimulation in Postinfarct Hemidystonia

“…Overall, secondary dystonia responds less favorably to DBS than primary dystonia [4,5,6,7,8,9]. Treatment with DBS specifically for dystonia secondary to ischemic stroke has been previously reported in 3 cases [5,8,10].…”