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Stereotact Funct Neurosurg. 2009;87(1):8-17. doi: 10.1159/000177623. Epub 2008 Nov 27.

Long-term efficacy and safety of chronic globus pallidus internus stimulation in different types of primary dystonia.

Author information

1
Neurochirurgische, Universitätsklinik, Klinikum Grosshadern, Ludwig-Maximilians-Universität München, München, Germany. jan.mehrkens@med.uni-muenchen.de

Abstract

BACKGROUND:

Deep brain stimulation (DBS) of the globus pallidus internus (GPi) offers a very promising therapy for medically intractable dystonia. However, little is known about the long-term benefit and safety of this procedure. We therefore performed a retrospective long-term analysis of 18 patients (age 12-78 years) suffering from primary generalized (9), segmental (6) or focal (3) dystonia (minimum follow-up: 36 months).

METHODS:

Outcome was assessed using the Burke-Fahn-Marsden (BFM) scores (generalized dystonia) and the Tsui score (focal/segmental dystonia). Follow-up ranged between 37 and 90 months (mean 60 months).

RESULTS:

Patients with generalized dystonia showed a mean improvement in the BFM movement score of 39.4% (range 0-68.8%), 42.5% (range -16.0 to 81.3%) and 46.8% (range -2.7 to 83.1%) at the 3- and 12-month, and long-term follow-up, respectively. In focal/segmental dystonia, the mean reduction in the Tsui score was 36.8% (range 0-100%), 65.1% (range 16.7-100%) and 59.8% (range 16.7-100%) at the 3- and 12-month, and long-term follow-up, respectively. Local infections were noted in 2 patients and hardware problems (electrode dislocation and breakage of the extension cable) in 1 patient.

CONCLUSION:

Our data showed Gpi-DBS to offer a very effective and safe therapy for different kinds of primary dystonia, with a significant long-term benefit in the majority of cases.

PMID:
19039258
DOI:
10.1159/000177623
[Indexed for MEDLINE]

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