Journal
JOURNAL OF NEUROSURGERY
Volume 112, Issue 6, Pages 1267-1270Publisher
AMER ASSOC NEUROLOGICAL SURGEONS
DOI: 10.3171/2009.10.JNS091062
Keywords
dystonia; deep brain stimulation; surgery; globus pallidus; thalamus; tremor; myoclonus; torticollis
Categories
Funding
- Medtronic
- Congress of Neurological Surgery
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Myoclonic dystonia is poorly managed with medication and may he severe enough to warrant surgical intervention. Surgery has targeted either the globus pallidus pars interim (G Pi) or the thalamus, but there is no accepted target for this condition. The authors present the case of a 23-year-old man treated with unilateral deep brain stimulation in both the thalamus and GPi. His movement disorder improved dramatically with stimulation. Two years postoperatively, the authors performed a double-blind assessment of the effects of each stimulator together. separately, and off stimulation. Videotape assessment, using tremor, dystonia, and myoclonus rating scales, showed that most of the benefit could be attributed to pallidal stimulation, although there was some advantage to stimulation at both sites. These results suggest that while GPi stimulation may be the better target for this condition. thalamic stimulation may be added in cases in which the benefit is insufficient. (DOI: 10.3171/2009.10.JNS091062)
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