| Abstract | Idiopathic cranial-cervical dystonia (ICCD) is an adult-onset dystonia syndrome affecting orbicularis oculi, facial, oromandibular, and cervical musculature. ICCD is frequently difficult to treat medically. Deep brain stimulation (DBS) of the globus pallidus internus (GPi) is a highly effective treatment for idiopathic generalized dystonia, however less is known about the effect of GPi DBS on ICCD. In this article, we present the results from a pilot study assessing the effect of GPi DBS in a series of patients with ICCD. Six patients underwent bilateral stereotactic implantation of DBS leads into the sensorimotor GPi. Patients were evaluated with the Burke-Fahn-Marsden dystonia rating scale (BFMDRS) and Toronto western spamodic torticollis rating scale (TWSTRS) before surgery and 6 months postoperatively. At 6 months, patients showed a 72% mean improvement in the BFMDRS total movement score (P < 0.028, Wilcoxin signed rank test). The mean BFMDRS disability score showed a trend toward improvement (P < 0.06). The total TWSTRS score improved 54% (P < 0.043). Despite improvement in dystonia, mild worsening of motor function was reported in previously nondystonic body regions with stimulation in 4 patients. Although GPi DBS was effective in these patients, the influence of GPi DBS on nondystonic body regions deserves further investigation. |
| Authors | Jill L Ostrem, William J Marks Jr, Monica M Volz, Susan L Heath, Philip A Starr
(Affiliation: Department of Neurology, University of California, San Francisco, California 94143, USA. jill.ostrem at ucsf.edu)
|
| Journal | Movement disorders : official journal of the Movement Disorder Society
(Mov Disord)
Vol. 22
Issue 13
Pg. 1885-91
(Oct 15 2007)
ISSN: 0885-3185 United States |
| PMID | 17618522
(Publication Type: Journal Article, Research Support, N.I.H., Extramural)
|
| Copyright | 2007 Movement Disorder Society |
| Topics |
- Adult
- Aged
- Deep Brain Stimulation
(adverse effects, instrumentation)
- Electrodes, Implanted
- Female
- Follow-Up Studies
- Globus Pallidus
(physiopathology)
- Humans
- Male
- Meige Syndrome
(physiopathology, therapy)
- Microcomputers
- Middle Aged
- Neurologic Examination
- Pilot Projects
- Pyramidal Tracts
(physiopathology)
- Torticollis
(physiopathology, therapy)
- Treatment Outcome
|
