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Stereotact Funct Neurosurg. 2010;88(5):304-10. doi: 10.1159/000316763. Epub 2010 Jun 24.

Long-term benefit sustained after bilateral pallidal deep brain stimulation in patients with refractory tardive dystonia.

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1
Department of Neurological Surgery, University of California, San Francisco, CA 94143, USA. ChangEd@neurosurg.ucsf.edu

Abstract

BACKGROUND/AIMS:

Tardive dystonia (TD) can be a highly disabling, permanent condition related to the use of dopamine-receptor-blocking medications. Our aim was to evaluate the long-term effect of bilateral pallidal deep brain stimulation (DBS) for TD.

METHODS:

Five consecutive patients with disabling TD who underwent stereotactic placement of bilateral globus pallidus internus DBS leads were included. All patients had a history of mood disorder or schizophrenia previously treated with neuroleptic medication, with a mean duration of motor symptoms of 10.2 years. Dystonia severity was measured using the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) movement score by a blinded neurologist reviewing pre- and postoperative videotaped examinations.

RESULTS:

The mean baseline movement BFMDRS score was 49.7 (range 20-88). Overall, we observed a mean reduction of 62% in the BFMDRS movement score within the first year after surgery. Persistent improvement in dystonia (71%) was seen at the last follow-up ranging from 2 to 8 years after surgery.

CONCLUSION:

Our experience suggests that pallidal DBS can be an effective therapy with long-term benefits for patients with TD.

PMID:
20588082
DOI:
10.1159/000316763
[Indexed for MEDLINE]
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