Camptocormia, characterised by a forward flexion of the thoracolumbar spine may occur in various
movement disorders, mainly in
Parkinson's disease or in
primary dystonia. In severe cases, patients with
camptocormia are unable to walk. While treatment options are limited,
deep brain stimulation (DBS) with bilateral stimulation of the subthalamic nucleus or globus pallidus internus (GPi) has been proposed as a therapeutic option in refractory cases of
Parkinson's disease. Here we present two patients with severe
camptocormia as an isolated form of
dystonia and as part of generalised
dystonia, respectively, which were both treated with bilateral stimulation of the GPi. Symptoms of
dystonia were assessed using the Burke-Fahn-Marsden
dystonia rating scale (BFM) before and during
deep brain stimulation. In both patients there was a significant functional improvement following long-term bilateral GPi stimulation and both patients gained ability to walk. In the first patient with an isolated dystonic
camptocormia the BFM motor subscore for the truncal flexion improved by 75 %. The total BFM motor score in the second patient with a
camptocormia in generalised
dystonia improved by 45 %, while the BFM score for truncal flexion improved by 87 %. In both patients the effect of the bilateral GPi stimulation on
camptocormia was substantial, independent of generalisation of
dystonia. Therefore, GPi DBS is a possible treatment option for this
rare disease.