Chronic Deep Brain Stimulation for Segmental Dystonia

Authors:
  • CBChristian Blahak
    Christian Blahak
  • KKKety Kekelia
    Kety Kekelia
  • HCHans-Holger Capelle
    Hans-Holger Capelle
  • HBHansjoerg Baezner
    Hansjoerg Baezner
  • EGEva Grips
    Eva Grips
  • RWRalf Weigel
    Ralf Weigel
  • JKJoachim K. Krauss
    Joachim K. Krauss
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Abstract
Fourteen consecutive patients with segmental dystonia underwent chronic deep brain stimulation (DBS) surgery in the frame of a prospective study protocol. Twelve patients received chronic pallidal stimulation, while 2 patients with prominent dystonic tremor received chronic thalamic ventrointermediate nucleus stimulation. Twelve patients had primary dystonia, and 2 patients secondary dystonia. The Burke-Fahn-Marsden dystonia rating scale (BFM motor) showed a mean relative improvement of 57.3% at the first follow-up (FU1, mean 7 months) and 57.8% at the second follow-up (FU2, mean 16 months). The mean BFM scores were 34.9 ± 17.7 preoperatively, 14.9 ± 11.7 at FU1, and 14.8 ± 10.3 at FU2. Scores of the disability subscale improved by 43% at FU1 and 36% at FU2. Improvement was comparatively less in those patients with secondary dystonia. Dysarthria was a limitation of DBS in 4 patients when using high voltage. Overall, chronic DBS is a very effective treatment option for medically refractory segmental dystonia.