[Update on multimodal neurosurgical management of dystonias]

The neurosurgical treatment of dystonia has progressed markedly since the introduction of deep brain stimulation of the globus pallidum interna. However, dystonia is not a single disorder but comprises various types and causes, and it is true that deep brain stimulation cannot cover the complex nature of dystonia. Depending on the distribution of symptoms and causes, we have to consider other surgical managements such as thalamotomy, peripheral denervation, and intrathecal baclofen. Such a multi-modal strategy has enabled us to treat and even cure many patients with dystonias. No treatment other than various neurosurgical approaches yields better results in the management of dystonias. In this sense, we are now at a stage where we should regard dystonia as a neurosurgical disorder in terms of treatment.