Long-term follow-up study of chronic globus pallidus internus stimulation for posttraumatic hemidystonia

J Neurosurg. 2000 Mar;92(3):457-60. doi: 10.3171/jns.2000.92.3.0457.

Abstract

The authors report the first case of chronic globus pallidus internus (GPi) stimulation for treatment of medically intractable hemidystonia for which long-term follow-up data are available. The patient had developed left-sided low-frequency tremor and hemidystonia after a severe head trauma sustained at 15 years of age. He experienced relief of the tremor but not of the hemidystonia after a thalamotomy was performed in the right hemisphere 3 years postinjury. When the patient was 24 years old, the authors performed a magnetic resonance-guided stereotactic implantation of a monopolar electrode in the right-sided posteroventral GPi. Chronic deep brain stimulation resulted in remarkable improvement of dystonia-associated pain, phasic dystonic movements, and dystonic posture, which was accompanied by functional gain. Postoperative improvement was sustained after 4 years of follow up. Chronic GPi stimulation appears to be a valuable treatment option for posttraumatic dystonia.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Brain Injury, Chronic / physiopathology
  • Brain Injury, Chronic / therapy*
  • Dominance, Cerebral / physiology*
  • Dystonia / etiology
  • Dystonia / physiopathology
  • Dystonia / therapy*
  • Electric Stimulation Therapy*
  • Follow-Up Studies
  • Globus Pallidus / physiopathology*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Stereotaxic Techniques
  • Tomography, X-Ray Computed
  • Treatment Outcome