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Vol. 89, No. 4, 2011
Issue release date: August 2011
Stereotact Funct Neurosurg 2011;89:205–209

Bilateral Globus Pallidus Internus Deep Brain Stimulation for DYT1+ Generalized Dystonia with Previously Received Bilateral Thalamotomy and Unilateral Pallidotomy

Kim J.P. · Chang W.S. · Park Y.S. · Chang J.W.
Department of Neurosurgery, Severance Hospital, Brain Korea 21 Project for Medical Science, Brain Research Institute, Yonsei University College of Medicine, Seoul, Korea

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Ablation of the globus pallidus internus (GPi) and thalamotomy have been extensively used in the past. Posteroventral GPi deep brain stimulation has been considered as a treatment for dystonia. However, to date, there is no report in the literature of any dystonia patient who underwent GPi deep brain stimulation who had previously undergone staged bilateral thalamotomy and unilateral pallidotomy. The authors of the present study have acquired relatively good clinical results, even in patients who previously received bilateral thalamotomy and unilateral pallidotomy for DYT1+ primary generalized dystonia.

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  1. Fahn S: Concept and classification of dystonia. Adv Neurol 1988;50:1–8.
  2. Yoshor D, Hamilton WJ, Ondo W, Jankovic J, Grossman RG: Comparison of thalamotomy and pallidotomy for the treatment of dystonia. Neurosurgery 2001;48:818–824.
  3. Goto S, Yamada K, Ushio Y: Subthalamic nucleus stimulation in a parkinsonian patient with previous bilateral thalamotomy. J Neurol Neurosurg Psychiatry 2004;75:164–165.
  4. Kleiner-Fisman G, Fisman DN, Zamir O, Dostrovsky JO, Sime E, Saint-Cyr JA, Lozano AM, Lang AE: Subthalamic nucleus deep brain stimulation for Parkinson’s disease after successful pallidotomy: clinical and electrophysiological observations. Mov Disord 2004;19:1209–1214.
  5. Mogilner AY, Sterio D, Rezai AR, Zonenshayn M, Kelly PJ, Beric A: Subthalamic nucleus stimulation in patients with a prior pallidotomy. J Neurosurg 2002;96:660–665.
  6. Moro E, Esselink RA, Van Blercom N, Caputo E, Pollak P, Limousin P, Hariz MI: Bilateral subthalamic nucleus stimulation in a parkinsonian patient with previous unilateral pallidotomy and thalamotomy. Mov Disord 2000;15:753–755.
  7. Ondo WG, Silay Y, Almaguer M, Jankovic J: Subthalamic deep brain stimulation in patients with a previous pallidotomy. Mov Disord 2006;21:1252–1254.
  8. Novak KE, Nenonene EK, Bernstein LP, Vergenz S, Cozzens JW, Rezak M: Successful bilateral subthalamic nucleus stimulation for segmental dystonia after unilateral pallidotomy. Stereotact Funct Neurosurg 2008;86:80–86.
  9. Krauss JK, Yianni J, Loher TJ, Aziz TZ: Deep brain stimulation for dystonia. J Clin Neurophysiol 2004;21:18–30.
  10. Cif L, Vasques X, Gonzalez V, Ravel P, Biolsi B, Collod-Beroud G, Tuffery-Giraud S, Elfertit H, Claustres M, Coubes P: Long-term follow-up of DYT1 dystonia patients treated by deep brain stimulation: an open-label study. Mov Disord 2010;25:289–299.

    External Resources

  11. Coubes P, Roubertie A, Vayssiere N, Hemm S, Echenne B: Treatment of DYT1-generalised dystonia by stimulation of the internal globus pallidus. Lancet 2000;355:2220–2221.
  12. Sun B, Chen S, Zhan S, Le W, Krahl SE: Subthalamic nucleus stimulation for primary dystonia and tardive dystonia. Acta Neurochir Suppl 2007;97:207–214.
  13. Kleiner-Fisman G, Liang GS, Moberg PJ, Ruocco AC, Hurtig HI, Baltuch GH, Jaggi JL, Stern MB: Subthalamic nucleus deep brain stimulation for severe idiopathic dystonia: impact on severity, neuropsychological status, and quality of life. J Neurosurg 2007;107:29–36.
  14. McIntyre CC, Savasta M, Walter BL, Vitek JL: How does deep brain stimulation work? Present understanding and future questions. J Clin Neurophysiol 2004;21:40–50.
  15. Delong MR, Georgopoulos AP, Crutcher MD, Mitchell SJ, Richardson RT, Alexander GE: Functional organization of the basal ganglia: contributions of single-cell recording studies. Ciba Found Symp 1984;107:64–82.
  16. Vayssiere N, van der Gaag N, Cif L, Hemm S, Verdier R, Frerebeau P, Coubes P: Deep brain stimulation for dystonia confirming a somatotopic organization in the globus pallidus internus. J Neurosurg 2004;101:181–188.
  17. Tisch S, Zrinzo L, Limousin P, Bhatia KP, Quinn N, Ashkan K, Hariz M: Effect of electrode contact location on clinical efficacy of pallidal deep brain stimulation in primary generalised dystonia. J Neurol Neurosurg Psychiatry 2007;78:1314–1319.

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