ORIGINAL COMMUNICATION

Journal of Neurology

, Volume 255, Issue 6, pp 881-884

First online:

Deep brain stimulation for dystonia: outcome at long-term follow-up

  • T. J. LoherAffiliated withDept. of Neurology, University of Berne, Inselspital
  • , H.-H. CapelleAffiliated withDept. of Neurosurgery, Medical University, MHH
  • , A. Kaelin-LangAffiliated withDept. of Neurology, University of Berne, Inselspital
  • , S. WeberAffiliated withDept. of Neurology, University of Berne, Inselspital
  • , R. WeigelAffiliated withDept. of Neurosurgery, University Hospital
  • , J. M. BurgunderAffiliated withDept. of Neurology, University of Berne, Inselspital
  • , J. K. KraussAffiliated withDept. of Neurosurgery, Medical University, MHH Email author 

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Abstract

Objective

Deep brain stimulation (DBS) has emerged as a useful therapeutic option for patients with insufficient benefit from conservative treatment.

Methods

Nine patients with chronic DBS who suffered from cervical dystonia (4), generalized dystonia (2), hemidystonia (1), paroxysmal dystonia (1) and Meige syndrome (1) were available for formal follow-up at three years postoperatively, and beyond up to 10 years. All patients had undergone pallidal stimulation except one patient with paroxysmal dystonia who underwent thalamic stimulation.

Results

Maintained improvement was seen in all patients with pallidal stimulation up to 10 years after surgery except in one patient who had a relative loss of benefit in dystonia ratings but continued to have improved disability scores. After nine years of chronic thalamic stimulation there was a mild loss of efficacy which was regained when the target was changed to the pallidum in the patient with paroxysmal dystonia. There were no major complications related to surgery or to chronic stimulation. Pacemakers had to be replaced within 1.5 to 2 years, in general.

Conclusion

DBS maintains marked long-term symptomatic and functional improvement in the majority of patients with dystonia.

Key words

deep brain stimulation dystonia long-term follow-up