Dystonia

2017 ◽  
Author(s):  
Jeri Yvonne Williams ◽  
David G Standaert
Keyword(s):  
Clinical Practice ◽  
Deep Brain Stimulation ◽  
Movement Disorder ◽  
Brain Stimulation ◽  
Age Of Onset ◽  
Anticholinergic Drugs ◽  
Body Parts ◽  
Botulinum Toxins ◽  
Deep Brain

Dystonia is a movement disorder characterized by sustained or intermittent muscle contractions. Classification of dystonia is based on age of onset, distribution of body parts affected, and underlying etiology. A large number of different genetic forms of dystonia have been discovered in recent years. Although these syndromes are important to recognize, the majority of dystonias encountered in clinical practice are of unknown cause. Therapy of dystonia includes medications, particularly anticholinergic drugs, use of botulinum toxins, and deep brain stimulation.

Deep Brain Stimulation in an Additional Patient With ADCY5-Related Movement Disorder

2016 ◽  
Vol 32 (4) ◽  
pp. 438-439 ◽  
Author(s):  
Inge A. Meijer ◽  
Joan Miravite ◽  
Brian H. Kopell ◽  
Naomi Lubarr
Keyword(s):  
Deep Brain Stimulation ◽  
Movement Disorder ◽  
Brain Stimulation ◽  
Additional Patient ◽  
Deep Brain

scholarly journals Longitudinal follow-up with VIM thalamic deep brain stimulation for dystonic or essential tremor

Neurology ◽  
2020 ◽  
Vol 94 (10) ◽  
pp. e1073-e1084 ◽  
Author(s):  
Takashi Tsuboi ◽  
Zakia Jabarkheel ◽  
Pamela R. Zeilman ◽  
Matthew J. Barabas ◽  
Kelly D. Foote ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Essential Tremor ◽  
Brain Stimulation ◽  
Rating Scale ◽  
Statistical Significance ◽  
Ventral Intermediate Nucleus ◽  
Deep Brain

ObjectiveTo assess longitudinal tremor outcomes with ventral intermediate nucleus deep brain stimulation (VIM DBS) in patients with dystonic tremor (DT) and to compare with DBS outcomes in essential tremor (ET).MethodsWe retrospectively investigated VIM DBS outcomes for 163 patients followed at our center diagnosed with either DT or ET. The Fahn-Tolosa-Marin tremor rating scale (TRS) was used to assess change in tremor and activities of daily living (ADL) at 6 months, 1 year, 2–3 years, 4–5 years, and ≥6 years after surgery.ResultsTwenty-six patients with DT and 97 patients with ET were analyzed. Compared to preoperative baseline, there were significant improvements in TRS motor up to 4–5 years (52.2%; p = 0.032) but this did not reach statistical significance at ≥6 years (46.0%, p = 0.063) in DT, which was comparable to the outcomes in ET. While the improvements in the upper extremity tremor, head tremor, and axial tremor were also comparable between DT and ET throughout the follow-up, the ADL improvements in DT were lost at 2–3 years follow-up.ConclusionOverall, tremor control with VIM DBS in DT and ET was comparable and remained sustained at long term likely related to intervention at the final common node in the pathologic tremor network. However, the long-term ADL improvements in DT were not sustained, possibly due to inadequate control of concomitant dystonia symptoms. These findings from a large cohort of DT indicate that VIM targeting is reasonable if the tremor is considerably more disabling than the dystonic features.Classification of evidenceThis study provides Class IV evidence that VIM DBS improves tremor in patients with DT or ET.

Successful bilateral deep brain stimulation of the globus pallidus internus for persistent status dystonicus and generalized chorea

2010 ◽  
Vol 113 (3) ◽  
pp. 634-638 ◽  
Author(s):  
Diana Apetauerova ◽  
Clemens M. Schirmer ◽  
Jay L. Shils ◽  
Janet Zani ◽  
Jeffrey E. Arle
Keyword(s):  
Deep Brain Stimulation ◽  
Movement Disorder ◽  
Globus Pallidus ◽  
Brain Stimulation ◽  
Globus Pallidus Internus ◽  
Battery Life ◽  
Status Dystonicus ◽  
Hyperkinetic Movement Disorder ◽  
Deep Brain ◽  
Stimulation Of

The authors report the cases of 2 young male patients (aged 16 and 26 years) with dystonic cerebral palsy of unknown origin, who developed status dystonicus, an acute and persistent combination of generalized dystonia and chorea. Both patients developed status dystonicus after undergoing general anesthesia, and in 1 case, after administration of metoclopramide. In attempting to control this acute hyperkinetic movement disorder, multiple medication trials failed in both cases and patients required prolonged intubation and sedation with propofol. Bilateral deep brain stimulation of the globus pallidus internus (4 and 2 months after the onset of symptoms in the first and second case, respectively) produced immediate resolution of the hyperkinetic movement disorder in each case. Deep brain stimulation provided persistent suppression of the dystonic movement potential after a follow-up of 30 and 34 months, respectively, as demonstrated by the reemergence of severe dystonia during the end of battery life of the implantable pulse generators that was readily controlled by exchange of the generators in each case.

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