Motor outcome of dystonic camptocormia treated with pallidal neurostimulation

Parkinsonism Relat Disord. 2014 Feb;20(2):176-9. doi: 10.1016/j.parkreldis.2013.10.022. Epub 2013 Nov 1.

Abstract

Background: Deep brain stimulation of the internal pallidum (GPi-DBS) is effective for various types of drug-refractory primary dystonias. Rare clinical forms as dystonic camptocormia may profit but available data are scarce.

Methods: We here report on a retrospective clinical assessment of three patients with primary dystonic camptocormia treated with GPi-DBS.

Results: All three patients showed marked response to bilateral GPi-DBS within days to weeks after surgery which was preserved in the long-term (38-45 months after implantation: mean improvement 82% as rated on the Burke Fahn Marsden Dystonia Rating Scale, 89% in the subitem "trunk"). Two patients developed mild stimulation induced speech problems (stuttering or dysarthria) which resolved with reprogramming or were acceptable in return for the control of dystonic symptoms.

Conclusions: The diagnosis and treatment of camptocormia will continue to require expert knowledge in movement and neuromuscular disorders, but DBS may expand treatment options in this difficult patient population.

Keywords: Camptocormia; Deep brain stimulation; Dystonia; Globus pallidus internus.

MeSH terms

  • Deep Brain Stimulation / methods*
  • Dystonic Disorders / therapy*
  • Electrodes, Implanted
  • Female
  • Globus Pallidus* / physiology
  • Globus Pallidus* / surgery
  • Humans
  • Male
  • Muscular Atrophy, Spinal / therapy*
  • Retrospective Studies
  • Spinal Curvatures / therapy*
  • Treatment Outcome

Supplementary concepts

  • Camptocormia