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Deep brain stimulation for dystonia: Patient selection and evaluation
Author(s) -
Volkmann Jens,
Benecke Reiner
Publication year - 2002
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.10151
Subject(s) - deep brain stimulation , dystonia , levodopa , medicine , movement disorders , physical medicine and rehabilitation , neurological disorder , dyskinesia , physical therapy , pediatrics , central nervous system disease , parkinson's disease , disease , surgery , psychiatry
Deep brain stimulation (DBS) for dystonia still needs to be considered investigational, because there are no controlled studies for this indication, the optimal target point is uncertain, and long‐term effects are unknown. The striking improvement of levodopa‐induced dyskinesias in Parkinson's disease by deep brain stimulation of the internal pallidum has encouraged the use of this therapy for generalized and severe segmental dystonia in children and adults. Single case and small cohort studies have reported impressive efficacy of pallidal DBS in patients with primary dystonia, especially DYT1 mutation carriers, but results in secondary dystonia are less conclusive. This article discusses the different factors influencing patient selection for surgical treatment and describes standardized methods and the caveats for clinical documentation of treatment results in dystonia. © 2002 Movement Disorder Society