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Risperidone-responsive segmental dystonia and pallidal deep brain stimulation.

J C Wöhrle1, R Weigel, E Grips

  • 1Departments of Neurology,Universitätsklinikum, Mannheim, Germany. woehrle@neuro.ma.uni-heidelberg.de

Neurology
|August 27, 2003
PubMed
Summary
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Deep brain stimulation (DBS) significantly improved symptoms in a patient with segmental dystonia. Combining DBS with medication showed the greatest benefit, warranting further study in similar cases.

Area of Science:

  • Neurology
  • Neurosurgery

Background:

  • Segmental dystonia is a movement disorder impacting specific body segments.
  • Deep brain stimulation (DBS) is an emerging treatment for refractory dystonia.
  • Risperidone is a medication sometimes used to manage dystonia symptoms.

Observation:

  • A 67-year-old male patient with risperidone-responsive segmental dystonia received bilateral globus pallidus internus DBS.
  • The Burke-Fahn-Marsden Dystonia Rating Scale was used to assess symptom severity.
  • Assessments were conducted in various medication and stimulation 'on'/'off' states.

Findings:

  • At 9 months post-DBS, the patient exhibited an 86% improvement in dystonia symptoms.
  • The best outcomes were observed when both DBS and risperidone medication were active (M-on/S-on).

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  • Significant improvement was also noted with DBS alone (M-off/S-on).

    • Implications:

    • Bilateral globus pallidus internus DBS is a viable treatment for segmental dystonia.
    • Concomitant use of DBS and medication may offer synergistic benefits.
    • Further research into combined DBS and pharmacotherapy for dystonia is recommended.