Premium
Pallidal stimulation for acquired dystonia due to cerebral palsy: beyond 5 years
Author(s) -
Romito L. M.,
Zorzi G.,
Marras C. E.,
Franzini A.,
Nardocci N.,
Albanese A.
Publication year - 2015
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.12596
Subject(s) - dystonia , deep brain stimulation , medicine , cerebral palsy , spasticity , rating scale , adverse effect , quality of life (healthcare) , movement disorders , physical medicine and rehabilitation , physical therapy , pediatrics , disease , parkinson's disease , psychology , psychiatry , developmental psychology , nursing
Background and purpose There is increasing evidence that deep brain stimulation ( DBS ) of the globus pallidus internus ( GP i) is effective in patients with idiopathic or inherited generalized dystonia. There is comparatively less experience about the effects of GP i DBS on acquired dystonia, particularly dystonia due to cerebral palsy ( DCP ). Clinical and demographic outcome predictors for DBS in dystonia syndromes are also poorly defined. Our aim was to examine the efficacy and safety of GP i DBS for the treatment of generalized DCP . Methods Fifteen patients with DCP up to 6.2 years after DBS surgery were studied. Only mild limb spasticity or mild static brain magnetic resonance imaging abnormalities were acceptable for inclusion. Dystonia severity and disability were assessed by the Burke−Fahn−Marsden dystonia rating scale (BFMDRS), and health‐related quality of life was assessed by the Short Form General Health Survey ( SF ‐36) scale. The amount of energy delivered was calculated, and adverse events and side effects were collected. Results At last follow‐up, BFMDRS motor score improved on average by 49.5%, and the disability score improved by 30%. Health‐related quality of life improved in most patients. Age at implant, age at onset and disease duration did not correlate to outcome, whilst higher pre‐operative dystonia severity and occurrence of spasticity were associated with poorer outcome. The patients received a stable amount of energy after the first 2 years post‐implant and throughout all the observation period. There were few serious adverse events or side effects. Conclusions The outcome was encouraging in the majority of DCP patients, with a stable outlook and a good safety profile.