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Pallidal deep brain stimulation in patients with cranial–cervical dystonia (Meige syndrome)
Author(s) -
Ostrem Jill L.,
Marks William J.,
Volz Monica M.,
Heath Susan L.,
Starr Philip A.
Publication year - 2007
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.21580
Subject(s) - cervical dystonia , deep brain stimulation , dystonia , torticollis , rating scale , movement disorders , medicine , focal dystonia , spasmodic torticollis , blepharospasm , stimulation , psychology , anesthesia , surgery , parkinson's disease , psychiatry , developmental psychology , disease
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. © 2007 Movement Disorder Society