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Use of Pallidal Deep Brain Stimulation in Postinfarct Hemidystonia

Witt J.a · Starr P.A.b · Ostrem J.L.a
Departments of aNeurology and bNeurological Surgery, University of California, San Francisco and Center for Movement Disorders, San Francisco, Calif., USA Stereotact Funct Neurosurg 2013;91:243-247 (DOI:10.1159/000345262)

Abstract

Background/Aims: Reports of outcomes in treating dystonia secondary to stroke with deep brain stimulation (DBS) are limited. We report our experience with 3 patients, all with infarcts involving the striatum, who developed hemidystonia and were treated with unilateral globus pallidus interna DBS. Methods: Case series describing characteristics and outcomes based on the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) scores before and after DBS at 3, 6 and at least 12 months. Results: All patients reported subjective improvements after surgery. At 1 year or more after surgery, none of the 3 patients displayed a measureable improvement in the BFMDRS movement score. Conclusion: Our findings are consistent with previous reports of limited benefits from pallidal DBS in secondary dystonia. Future work should focus on predictive factors for DBS outcomes and the development of more sensitive assessment tools specifically for secondary dystonias as well as the exploration of alternative brain targets for stimulation.

 

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