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Published on: August 12, 2018

Deep brain stimulation for torsion dystonia.

R L Alterman1, B J Snyder

  • 1Department of Neurosurgery, Mount Sinai School of Medicine, New York, New York 10029, USA. ron.alterman@mountsinai.org

Acta Neurochirurgica. Supplement
|August 19, 2007
PubMed
Summary

Deep brain stimulation (DBS) of the globus pallidus pars internus effectively treats medically refractory torsion dystonia, particularly primary generalized forms and those with the DYT1 gene mutation.

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Area of Science:

  • Neurology
  • Neurosurgery

Background:

  • Torsion dystonia is a movement disorder requiring effective treatments.
  • Globus pallidus pars internus (GPi) deep brain stimulation (DBS) is a recognized therapy.

Purpose of the Study:

  • To review the classification and treatment of torsion dystonia.
  • To discuss indications, procedures, and programming for GPi DBS.
  • To evaluate the efficacy of GPi DBS across different dystonia subtypes.

Main Methods:

  • Review of existing literature on torsion dystonia and GPi DBS.
  • Analysis of patient outcomes based on dystonia classification and genetic factors.
  • Discussion of surgical procedures and device programming.

Main Results:

  • Pallidal DBS is most effective for primary generalized dystonia, especially in DYT1-positive children and adolescents.
  • Patients with cervical dystonia may benefit, though evidence is limited.
  • Secondary dystonias generally respond less well, with exceptions for anoxic injury and tardive dystonia.

Conclusions:

  • GPi DBS is a valuable treatment for specific torsion dystonia populations.
  • Patient selection based on dystonia type and genetic profile is crucial for optimal outcomes.
  • Further research is needed for definitive evidence in certain subtypes like cervical dystonia.

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Targeting Neuronal Fiber Tracts for Deep Brain Stimulation Therapy Using Interactive, Patient-Specific Models
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