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Stereotactic and Functional Neurosurgery pp 311–327Cite as

Dystonia

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Abstract

Dystonia is a multifaceted movement disorder causing a range of types of involuntary movement. Two axes are used to distinguish different subtypes of dystonia: clinical aspects (time of onset and distribution of symptoms) and etiology (e.g., primary vs. secondary). Patients who are not adequately treated with medical therapy are referred for surgical treatment, which primarily consists of deep brain stimulation. The pallidum is the most common target for treatment of dystonia and has been shown to be effective for the heterogenous group of dystonia disorders. Other deep brain stimulation targets can also be considered. Deep brain stimulation can be performed using a variety of techniques, both awake and asleep, both with and without microelectrode recording, with a frame and frameless, and with a variety of image-guided approaches. There are some special considerations for dystonia patients that should be considered when determining the appropriate surgical treatment. New techniques for ablation have reintroduced pallidotomy as a potential surgical treatment in select cases.

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Authors and Affiliations

  1. Department of Neurological Surgery, Johns Hopkins University, Baltimore, MD, USA

    Teresa Wojtasiewicz & William Stanley Anderson

  2. Departments of Neurology, Psychiatry & Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA

    Ankur Butala

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  1. Teresa Wojtasiewicz
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  2. Ankur Butala
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Correspondence to Teresa Wojtasiewicz .

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  1. Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    Nader Pouratian

  2. Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA

    Sameer A. Sheth

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Wojtasiewicz, T., Butala, A., Anderson, W.S. (2020). Dystonia. In: Pouratian, N., Sheth, S. (eds) Stereotactic and Functional Neurosurgery. Springer, Cham. https://doi.org/10.1007/978-3-030-34906-6_22

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