Clinical Study

Chronic Deep Brain Stimulation for Segmental Dystonia
Johannes C. Woehrle^{a, d}, Christian Blahak^a, Kety Kekelia^b, Hans-Holger Capelle^{b, c}, Hansjoerg Baezner^a, Eva Grips^a, Ralf Weigel^b, Joachim K. Krauss^{b, c}

Departments of
^aNeurology and
^bNeurosurgery, Universitätsklinikum Mannheim, Mannheim,
^cDepartment of Neurosurgery, Medical School Hannover, MHH, Hannover, and
^dDepartment of Neurology, Katholisches Klinikum, Koblenz, Germany

Address of Corresponding Author

Stereotact Funct Neurosurg 2009;87:379-384 (DOI: 10.1159/000249819)

  Key Words

• Segmental dystonia
• Deep brain stimulation
• Globus pallidus internus
• Thalamus

  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.

Copyright © 2009 S. Karger AG, Basel

  Author Contacts

Prof. Dr. med. J.K. Krauss
Department of Neurosurgery, Medical School Hannover, MHH
Carl Neuberg Strasse 1
DE-30652 Hannover (Germany)
Tel. +49 511 532 6650, Fax +49 511 532 5864, E-Mail krauss.joachim@mh-hannover.de

  Article Information

J.K.K. is a consultant to Medtronic. H.-H.C. has received speaker's honoraria from Medtronic.

Received: April 23, 2009
Accepted after revision: July 28, 2009
Published online: October 21, 2009
Number of Print Pages : 6
Number of Figures : 1, Number of Tables : 1, Number of References : 19