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Evaluation of the efficacy of deep brain stimulation in the surgical treatment of cervical dystonia
Affiliation:1. Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, London, United Kingdom;2. Department of Neurological and Movement Sciences, University of Verona, Verona, Italy;3. Fondazione IRCCS Ca'' Granda, Ospedale Maggiore Policlinico, Milano, Italy;4. Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Milano, Italy
Abstract:ObjectiveDeep brain stimulation (DBS) of the globus pallidus internus (GPi) is a promising therapeutic option for patients with medically refractory dystonia. We present the results after 1 year of DBS of the GPi in 4 patients with cervical dystonia.Materials and methodsFour patients with medically refractory cervical dystonia who underwent stereotactic pallidal DBS surgery between June 2010 and November 2011 were included in this retrospective study. Preoperative and postoperative evaluations at 3, 6 and 12 months after surgery were performed using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS).ResultsThe 4 patients experienced a sustained improvement, with a mean TWSTRS reduction of 74.25%, at 12 months follow-up. Disability improved by 80.5% (mean) at 1 year follow-up. No stimulation-related side effects were reported.ConclusionPallidal DBS is a valid and effective second-line treatment for patients with cervical focal dystonia. Our results support its use in patients with an insufficient response to medical treatment.
Keywords:Deep brain stimulation  Focal idiopathic dystonia  Cervical dystonia  Movement disorder  Globus pallidus  Botulinum toxins  Estimulación cerebral profunda  Distonía focal idiopática  Distonía cervical  Trastornos del movimiento  Globo pálido  Toxinas botulínicas
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