Abstract
Dystonia is a movement disorder characterized by patterned, repetitive, phasic, or tonic sustained muscle contractions that produce abnormal, often twisting, postures or repetitive movements. When the disorder is genetic or the cause is unknown and dystonia is the sole feature, the disease is called primary or idiopathic, conversely secondary dystonia (SD) may be caused by various brain insults. Both primary dystonia and SD have been notorious for their poor response to medical treatment. Today, stereotactic neurosurgical procedures are offered to improve the disability and quality of life of patients who do not respond to medical therapy. However, SD shows less and more variable results than primary dystonia to neurosurgical procedures, the benefits of ablative or deep brain stimulation (DBS) procedures in basal structures being still subject to debate and much harder to fully appreciate. In this work, the authors show a 33-patient series with secondary dystonia, separating the statistic and clinical analysis into several etiology groups: perinatal insults, tardive syndromes, genetic syndromes, and posttraumatic. In these groups, we show the mean BFM score improvement in the different patient series, comparing our results with world literature, and finally propose a classification system for bettering the clinical approach in surgery decision when this is indicated.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Capelle H, Krauss J (2009) Functional stereotactic procedures for treatment of secondary dystonia. In: Lozano A, Gildenberg P, Tasker R (eds) Textbook of stereotactic and functional neurosurgery. Springer, Berlin, pp 1835–1856
Eltahawy H, Saint-Cyr J, Giladi N, Lang A, Lozano A (2004) Primary dystonia is more responsive than secondary dystonia to pallidal interventions: outcome after pallidotomy or pallidal deep brain stimulation. Neurosurgery 54:613–621
Geyer HL, Bressman SB (2007) Diagnosis of dystonia. In: Warner TT, Bressman SB (eds) Clinical diagnosis and management of dystonia. Informa healthcare, London, pp 1–14
Iacono RP, Kuniyoshi SM, Lonser RR, Maeda G, Inae AM, Ashwal S (1996) Simultaneous bilateral pallidoansotomy for idiopathic dystonia musculorum deformans. Pediatr Neurol 14:145–148
Krause M, Fogel W, Kloss M, Rasche D, Volkmann J (2004) Pallidal stimulation for dystonia. Neurosurgery 55:1361–1370
Iacono RP, Kuniyoshi SM, Schoonenberg T (1998) Experience with stereotactics for dystonia: case examples. Adv Neurol 78:221–226
Lin JJ, Lin SZ, Lin GY, Chang DC, Lee CC (1998) Application of bilateral sequential pallidotomy to treat a patient with generalized dystonia. Eur Neurol 40:108–110
Lin JJ, Lin GY, Shih C, Lin SZ, Chang DC, Lee CC (1999) Benefit of bilateral pallidotomy in the treatment of generalized dystonia: case report. J Neurosurg 90:974–976
Lozano AM, Kumar R, Gross RE, Giladi N, Hutchison WD, Dostrovsky JO, Lang AE (1997) Globus pallidus internus pallidotomy for generalized dystonia. Mov Disord 12:865–870
Vitek JL (1998) Surgery for dystonia. Neurosurg Clin N Am 9:345–366
Vitek JL, Zhang J, Evatt M, Mewes K, DeLong MR, Hashimoto T, Triche S, Bakay RAE (1998) GPi pallidotomy for dystonia: clinical outcome and neuronal activity. Adv Neurol 78:211–219
Krauss JK, Yianni J, Loher TJ, Aziz TZ (2004) Deep brain stimulation for dystonia. J Clin Neurophysiol 21:18–30
Welter M, Grabli D, Vidailhet M (2010) Deep brain stimulation for hyperkinetic disorders: dystonia, tardive dyskinesia and tics. Curr Opin Neurol 23:420–425
Vercueil L, Pollak P, Fraix V, Caputo E, Moro E, Benazzouz A et al (2001) Deep brain stimulation in the treatment of severe dystonia. J Neurol 248:695–700
Cif L, El Fertit H, Vayssiere N, Hemm S, Hardouin E, Gannau A, Tuffery S, Coubes P (2003) Treatment of dystonic syndromes by chronic electrical stimulation of the internal globus pallidus. J Neurosurg Sci 47:52–55
Aziz T, Green A (2009) Dystonia: a surgeon’s perspective. Parkinsonism Relat Disord 15S(3):S75–S80
Katsakiori PF, Kefalopoulou Z, Markaki E, Paschali A, Ellul J, Kagadis GC et al (2009) Deep brain stimulation for secondary dystonia: results in 8 patients. Acta Neurochir 151(5):473–478
Lin JJ, Lin SZ, Chang DC (1999) Pallidotomy and generalized dystonia. Mov Disord 14:1057–1059
Ondo WG, Krauss JK (2003) Surgical therapies for dystonia. In: Brin MF, Comella C, Jankovic J (eds) Dystonia monograph. Lippincott, Williams & Wilkins, Philadelphia, pp 125–147
Trottenberg T, Volkmann J, Deuschl G, Kuhn AA, Schneider GH, Muller J et al (2005) Treatment of severe tardive dystonia with pallidal deep brain stimulation. Neurology 64:344–346
Arnone D, Hansen L, Kerr JS (2002) Acute dystonic reaction in an elderly patient with mood disorder after titration of paroxetine: possible mechanisms and implications for clinical care. J Psychopharmacol 16:395–397
Sako W, Goto S, Shimazu H, Murase N, Matsuzaki K, Tamura T et al (2008) Bilateral deep brain stimulation of the globus pallidus internus in tardive dystonia. Mov Disord 23:1929–1931
Damier P, Thobois S, Witjas T, Cuny E, Derost P, Raoul S et al (2007) French Stimulation for Tardive Dyskinesia (STARDYS) Study Group. Bilateral deep brain stimulation of the globus pallidus to treat tardive dyskinesia. Arch Gen Psychiatry 64:170–176
Vidailhet M, Lagrannge C, Welter ML, Krack P, Krystowiak P, Burbaud P et al (2008) Bilateral pallidal stimulation in generalized dystonia related to post-anoxic birth injury: multicentre study. Mov Disord Suppl 1:162
Vidailhet M, Yelnik J, Lagrange C et al (2009) Bilateral pallidal deep brain stimulation for the treatment of patients with dystonia-choreoathetosis cerebral palsy: a prospective pilot study. Lancet Neurol 8:709–717
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
Loher TJ, Hasdemir MG, Burgunder JM, Krauss JK (2000) Long-term follow-up study of chronic globus pallidus internus stimulation for posttraumatic hemidystonia. J Neurosurg 92:457–460
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
Motta F, Antonello C, Stignani C (2009) Upper limbs function after intrathecal baclofen therapy in children with secondary dystonia. J Pediatr Orthop 29:817–821
Butler C, Campbell S (2000) Evidence of the effects of intrathecal baclofen for spastic and dystonic cerebral palsy. Dev Med Child Neurol 42(9):634–645
Albright AL, Ferson SS (2006) Intrathecal baclofen therapy in children. Neurosurg Focus 21(2):e3
Narayan RK, Loubser PG, Jankovic J et al (1991) Intrathecal baclofen for intractable axial dystonia. Neurology 41(7):1141–1142
Penn RD, Gianino JM, York MM (1995) Intrathecal baclofen for motor disorders. Mov Disord 10(5):675–677
Ford B, Green P, Louis E, Petzinger G, Bressman S, Goodman R et al (1996) Use of intrathecal baclofen in the treatment of patients with dystonia. Arch Neurol 53:1241–1246
Albright AL, Barry MJ, Shafron DH, Ferson SS (2001) Intrathecal baclofen for generalized dystonia. Dev Med Child Neurol 43:652–657
Albright AL (1996) Intrathecal baclofen in cerebral palsy movement disorders. J Child Neurol 11:S29–S35
Albright AL, Barry MJ, Painter MJ, Shultz B (1998) Infusion of intrathecal baclofen for generalized dystonia in cerebral palsy. J Neurosurg 88:73–76
Motta F, Stignani C, Antonello CE (2008) Effect of intrathecal baclofen on dystonia in children with cerebral palsy and the use of functional scales. J Pediatr Orthop 28:213–217
Ward A, Hayden S, Dexter M, Scheinberg A (2009) Continuous intrathecal baclofen for children with spasticity and/or dystonia: goal attainment and complications associated with treatment. J Paediatr Child Health 45:720–726
Albright AL, Barry MJ, Fasick P, Barron W, Shultz B (1996) Continuous intrathecal baclofen infusion for symptomatic generalized dystonia. Neurosurgery 38:934–939
Albright AL (2007) Intrathecal baclofen for childhood hypertonia. Childs Nerv Syst 23:971–979
Albright AL (1996) Baclofen in the treatment of cerebral palsy. J Child Neurol 11(2):77–83
Conflict of Interest
We declare that we have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer-Verlag Wien
About this paper
Cite this paper
Martinez, J.A.E., Vidarte, O.A.E., Uribe, G.A. (2013). Functional Neurosurgery for Secondary Dystonia: Indications and Long-Term Results. In: Nikkhah, G., Pinsker, M. (eds) Stereotactic and Functional Neurosurgery. Acta Neurochirurgica Supplement, vol 117. Springer, Vienna. https://doi.org/10.1007/978-3-7091-1482-7_10
Download citation
DOI: https://doi.org/10.1007/978-3-7091-1482-7_10
Published:
Publisher Name: Springer, Vienna
Print ISBN: 978-3-7091-1481-0
Online ISBN: 978-3-7091-1482-7
eBook Packages: MedicineMedicine (R0)