Chronic Deep Brain Stimulation for Segmental DystoniaWoehrle J.C. · Blahak C. · Kekelia K. · Capelle H.-H. · Baezner H. · Grips E. · Weigel R. · Krauss J.K.
Departments of aNeurology and bNeurosurgery, Universitätsklinikum Mannheim, Mannheim, cDepartment of Neurosurgery, Medical School Hannover, MHH, Hannover, and dDepartment of Neurology, Katholisches Klinikum, Koblenz, Germany
Fourteen consecutive patients with segmental dystonia underwent chronic deep brain stimulation (DBS) surgery in the frame of a prospective study protocol. Twelve patients received chronic pallidal stimulation, while 2 patients with prominent dystonic tremor received chronic thalamic ventrointermediate nucleus stimulation. Twelve patients had primary dystonia, and 2 patients secondary dystonia. The Burke-Fahn-Marsden dystonia rating scale (BFM motor) showed a mean relative improvement of 57.3% at the first follow-up (FU1, mean 7 months) and 57.8% at the second follow-up (FU2, mean 16 months). The mean BFM scores were 34.9 ± 17.7 preoperatively, 14.9 ± 11.7 at FU1, and 14.8 ± 10.3 at FU2. Scores of the disability subscale improved by 43% at FU1 and 36% at FU2. Improvement was comparatively less in those patients with secondary dystonia. Dysarthria was a limitation of DBS in 4 patients when using high voltage. Overall, chronic DBS is a very effective treatment option for medically refractory segmental dystonia.
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