7. Deep Brain Stimulation in Dystonia

  1. Sam Eljamel2 and
  2. Konstantin V. Slavin3
  1. Ludvic Zrinzo

Published Online: 19 JUL 2013

DOI: 10.1002/9781118346396.ch7

Neurostimulation: Principles and Practice

Neurostimulation: Principles and Practice

How to Cite

Zrinzo, L. (2013) Deep Brain Stimulation in Dystonia, in Neurostimulation: Principles and Practice (eds S. Eljamel and K. V. Slavin), John Wiley & Sons, Ltd, Oxford, UK. doi: 10.1002/9781118346396.ch7

Editor Information

  1. 2

    Centre for Neurosciences, Ninewells Hospital & Medical School, Dundee, Scotland, UK

  2. 3

    Department of Neurosurgery, University of Illinois at Chicago. Chicago, Illinois, USA

Author Information

  1. UCL Institute of Neurology, University College London, and National Hospital for Neurology and Neurosurgery, London, UK

Publication History

  1. Published Online: 19 JUL 2013
  2. Published Print: 19 AUG 2013

ISBN Information

Print ISBN: 9781118346358

Online ISBN: 9781118346396

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Keywords:

  • Burke—Fahn—Marsden dystonia rating scale (BFM);
  • deep brain stimulation (DBS);
  • dystonia;
  • patient selection;
  • TWSTRS

Summary

Numerous distinct pathophysiological mechanisms may result in dystonia most common movement disorder in humans. Dystonia with numerous monogenetic loci (DYT) mutations have variable penetrance and may give rise to one of three phenotypes: primary dystonia, dystonia plus (with additional signs such as parkinsonism or myoclonus), and paroxysmal forms of dystonia/dyskinesia. The posteroventral pallidum has emerged as the most popular target for deep brain stimulation (DBS) in the management of dystonia. Numerous dystonia scales have been employed to assess specific types of dystonia. The two most commonly employed scales are the Burke—Fahn— Marsden dystonia rating scale (BFM) and the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS). Pallidal DBS can significantly improve motor scores and quality of life in well‐selected patients with dystonia. A multidisciplinary approach by a dedicated functional neurosurgery team that places an emphasis on patient safety and life long follow‐up is required to achieve the best possible clinical results.