Surgical treatment for secondary dystonia.

Abstract

Surgical therapy for the secondary dystonias is generally perceived to be less effective than for primary disease. However, a number of case reports and small open series have recently appeared describing quite favorable outcomes following surgery for some nonprimary dystonias. We discuss surgical treatment options for this group of diverse conditions, including tardive dystonia, dystonic cerebral palsy, and certain heredodegenerative diseases in which deep brain stimulation and ablative lesions of the posteroventral pallidum have been shown to be effective. Other types of secondary dystonia respond less well to pallidal surgery, particularly when anatomical lesions of the basal ganglia are prominent on preoperative imaging. For these conditions, central baclofen delivery and botulinum toxin denervation may be considered. With optimal medical and surgical care, some patients with secondary dystonia have achieved reductions in disability and pain that approach those documented for primary dystonia.

• Authors: Travis S Tierney, Andres M Lozano
• Journal: Movement disorders : official journal of the Movement Disorder Society (Mov Disord) Vol. 27 Issue 13 Pg. 1598-605 (Nov 2012) ISSN: 1531-8257 [Electronic] United States
• PMID: 23037556 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)
• Copyright: Copyright © 2012 Movement Disorder Society.

Chemical References

• Botulinum Toxins
• Baclofen

Topics

• Baclofen (pharmacology)
• Basal Ganglia (drug effects, physiology)
• Botulinum Toxins (pharmacology)
• Denervation (methods)
• Dystonic Disorders (therapy)
• Globus Pallidus (drug effects, physiology)
• Humans
• Neurosurgery (methods)