Skip to main content

Deep brain stimulation for torsion dystonia

  • Chapter
Operative Neuromodulation

Part of the book series: Acta Neurochirurgica Supplements ((NEUROCHIRURGICA,volume 97/2))

Abstract

Deep brain stimulation (DBS) at the globus pallidus pars internus (GPi) is an effective treatment for some patients with medically refractory torsion dystonia. In this chapter we review the classification and treatment of torsion dystonia including the current indications for DBS surgery. Details of the DBS procedure and programming of the DBS devices are discussed. Pallidal DBS is most effective in patients with primary generalized dystonia. Children and adolescents possessing the DYT1 gene mutation may respond best of all. Patients with cervical dystonia may also improve with pallidal DBS but definitive clinical evidence is lacking. As a group, patients with secondary dystonias respond less well to DBS than do patients with primary dystonia; however, patients with dystonia secondary to anoxic brain injury who have grossly intact basal ganglia anatomy, and patients with tardive dystonia may represent secondary dystonia subtypes for whom pallidal DBS is a viable option.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 299.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Bertrand CM, Molina-Negro P (1988) Selective peripheral denervation in 111 cases of spasmodic torticollis: rationale and results. Adv Neurol 50: 637–643

    PubMed  CAS  Google Scholar 

  2. Bittar RG, Yianni J, Wang SY, Liu X, Nandi K, Joint C, Scott R, Bain PG, Gregory R, Stein J, Aziz T (2005) Deep brain stimulation for generalized dystonia and spasmodic torticollis. J Clin Neurosci 12: 12–16

    Article  PubMed  Google Scholar 

  3. Bressman SB (2003) Dystonia: phenotypes and genotypes. Rev Neurol (Paris) 159: 849–856

    PubMed  CAS  Google Scholar 

  4. Coubes P, Cif L, El Fertit H, Hemm S, Vayssiere N, Serrat S, Picot MC, Tuffery S, Claustres M, Echenne B, Frerebeau P (2004) Electrical stimulation of the globus pallidus internus in patients with primary generalized dystonia: long-term results. J Neurosurg 101: 189–194

    PubMed  Google Scholar 

  5. Coubes P, Echenne B, Roubertie A, Vayssiere N, Tuffery S, Humbertclaude V, Cambonie G, Claustres M, Frerebeau P (1999) Treatment of early-onset generalized dystonia by chronic bilateral stimulation of the internal globus pallidus. Apropos of a case. Neurochirurgie 45: 139–144

    PubMed  CAS  Google Scholar 

  6. Defazio G, Abbruzzese G, Livrea P, Berardelli A (2004) Epidemiology of primary dystonia. Lancet Neurol 3: 673–678

    Article  PubMed  Google Scholar 

  7. Detante O, Vercueil L, Krack P, Chabardes S, Benabid AL, Pollak P (2004) Off-period dystonia in Parkinson’s disease but not generalized dystonia is improved by high-frequency stimulation of the subthalamic nucleus. Adv Neurol 94: 309–314

    PubMed  Google Scholar 

  8. Elthaway H, Saint-Cyr J, Giladi N, Lang A, Lozano AM (2004) Primary dystonia is more responsive than secondary dystonia to pallidal interventions: outcome after pallidotomy or pallidal deep brain stimulation. Neurosurg 54: 613–621

    Article  Google Scholar 

  9. Fahn S (1994) Idiopathic torsion dystonia. In: Calne DB (ed) Neurodegenerative diseases. Saunders WB, Philadelphia, pp 705–715

    Google Scholar 

  10. Ford B, Greene P, Louis ED, Petzinger G, Bressman SB, Goodman R, Brin MF, Sadiq S, Fahn S (1996) Use of intrathecal baclofen in the treatment of patients with dystonia. Arch Neurol 53: 1241–1246

    PubMed  CAS  Google Scholar 

  11. Greene P, Fahn S, Diamond B (1994) Development of resistance to botulinum toxin type A in patients with torticollis. Mov Disord 9: 213–217

    Article  PubMed  CAS  Google Scholar 

  12. Hua Z, Guodong G, Qinchuan L, Yaqun Z, Qinfen W, Xuelian W (2003) Analysis of complications of radiofrequency pallidotomy. Neurosurgery 52: 89–99

    Article  PubMed  Google Scholar 

  13. Krauss JK, Loher TJ, Weigel R, Capelle HH, Weber S, Burgunder JM (2003) Chronic stimulation of the globus pallidus internus for treatment of non-dYT1 generalized dystonia and choreoathetosis: 2-year follow up. J Neurosurg 98: 785–792

    PubMed  Google Scholar 

  14. Laitinen LV, Bergenheim AT, Hariz MI (1992) Leksell’s posteroventral pallidotomy in the treatment of Parkinson’s disease. J Neurosurg 76: 53–61

    Article  PubMed  CAS  Google Scholar 

  15. Kumar R, Dagher A, Hutchison WD, Lang AE, Lozano AM (1999) Globus pallidus deep brain stimulation for generalized dystonia: clinical and PET investigation. Neurology 53: 871–874

    PubMed  CAS  Google Scholar 

  16. Lozano AM, Lang AE, Galvez-Jimenez N, Miyasaki J, Duff J, Hutchinson WD, Dostrovsky JO (1995) Effect of GPi pallidotomy on motor function in Parkinson’s disease. Lancet 346: 1383–1387

    Article  PubMed  CAS  Google Scholar 

  17. Ondo WG, Desaloms JM, Jankovic J, Grossman RG (1998) Pallidotomy for generalized dystonia. Mov Disord 13: 693–698

    Article  PubMed  CAS  Google Scholar 

  18. Shils J, Tagliati M, Alterman R (2002) Neurophysiological monitoring during neurosurgery for movement disorders. In: Deletis V, Shils J (eds) Neurophysiology in neurosurgery. San Diego, Academic Press, pp 393–436

    Google Scholar 

  19. Sun B, Li D, Sun C, Liu D, Zhao Y, Shen J, Chen S (2003) Target selection for primary dystonia deep brain stimulation: GPi or STN? ASSFN Proceedings, New York, NY, p 91

    Google Scholar 

  20. Tagliati M, Blatt K, Bressman SB (2003) Generalized torsion dystonia. In: Noseworthy J (ed) Neurological therapeutics: principles and practice. Martin Dunitz Ltd., London

    Google Scholar 

  21. Trottenberg T, Volkmann J, Deuschl G, Kuhn AA, Schneider GH, Muller J, Alesch F, Kupsch A (2005) Treatment of severe tardive dystonia with pallidal deep brain stimulation. Neurology 64: 344–346

    PubMed  CAS  Google Scholar 

  22. Vidailhet M, Vercueil L, Houeto JL, Krystkowiak P, Benabid AL, Cornu P, Lagrange C, Tezenas du Montcel S, Dormont D, Grand S, Blond S, Detante O, Pillon B, Ardouin C, Agid Y, Destee A, Pollak P, French Stimulation du Pallidum Interne dans la Dystonie (SPIDY) Study Group (2005) Bilateral deep brain stimulation of the globus pallidus in primary generalized dystonia. N Engl J Med 352: 459–467

    Article  PubMed  CAS  Google Scholar 

  23. Volkmann J, Benecke R (2002) Deep brain stimulation for dystonia: patient selection and evaluation. Mov Disord 17Suppl 3: S112–S115

    Article  PubMed  Google Scholar 

  24. Yianni J, Bain P, Giladi N, Auca M, Gregory R, Joint C, Nandi D, Stein J, Scott R, Aziz T (2003) Globus pallidus internus deep brain stimulation for dystonic conditions: a prospective audit. Mov Disord 18: 436–442

    Article  PubMed  Google Scholar 

  25. Yianni J, Nandi D, Shad A, Bain P, Gregory R, Aziz T (2004) Increased risk of lead fracture and migration in dystonia compared with other movement disorders following deep brain stimulation. J Clin Neurosci 11: 243–245

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ron L. Alterman .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2007 Springer-Verlag

About this chapter

Cite this chapter

Alterman, R.L., Snyder, B.J. (2007). Deep brain stimulation for torsion dystonia. In: Sakas, D.E., Simpson, B.A. (eds) Operative Neuromodulation. Acta Neurochirurgica Supplements, vol 97/2. Springer, Vienna. https://doi.org/10.1007/978-3-211-33081-4_21

Download citation

  • DOI: https://doi.org/10.1007/978-3-211-33081-4_21

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-211-33080-7

  • Online ISBN: 978-3-211-33081-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics