Deep brain stimulation in the treatment of severe dystonia
Journal of Neurology. 2001-08-01; 248(8): 695-700
DOI: 10.1007/s004150170116
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1. J Neurol. 2001 Aug;248(8):695-700. doi: 10.1007/s004150170116.
Deep brain stimulation in the treatment of severe dystonia.
Vercueil L(1), Pollak P, Fraix V, Caputo E, Moro E, Benazzouz A, Xie J, Koudsie
A, Benabid AL.
Author information:
(1)Neurology Department, CHU Grenoble, France.
A retrospective study of a consecutive series of 19 patients with medically
intractable dystonia treated with uni- or bilateral deep brain stimulation (DBS)
is reported. A minimal follow-up of 6 months was available, up to eleven years
in one patient. The first twelve consecutive patients (4 with primary and 8 with
secondary dystonia) were treated with chronic stimulation of the posterior part
of the ventrolateral thalamic nucleus (VLp). In this group global functional
outcome was improved in 8 patients, although dystonia movement and disability
scale scores did not show significant improvement. Of the 12 patients treated
first by VLp DBS, three (1 primary and 2 secondary dystonia) underwent pallidal
(GPi) DBS after the VLp DBS failed to improve their symptoms. The last seven
consecutive patients (5 primary and 2 secondary dystonia) were treated directly
with GPi DBS. Extracranial infection prevented chronic GPi DBS in one patient.
In another GPi patient, preliminary negative tests with the electrodes
discouraged implantation of the stimulators, and the patient was not treated
with chronic DBS. In the remaining group of eight patients including those
previously treated with VLp DBS, chronic GPi DBS resulted in a significant
improvement in the dystonia movement scale and disability scores. Although this
is a retrospective study dealing with dystonia of heterogeneous etiology, the
results strongly suggest that GPi DBS has a better outcome than VLp DBS.
DOI: 10.1007/s004150170116
PMID: 11569899 [Indexed for MEDLINE]