Ultrasound-Guided Cryoneurolysis for Peripherally Induced Dystonia After Non-neurological Surgery: A Case Series

Current dystonia classifications define acquired dystonia through central nervous system (CNS)-centric etiologies without delineating how peripheral nerve injury following non-neurological surgery produces the dystonic phenotype. Dystonia is frequently confused with spasticity, contributing to misdiagnosis. Three female patients (ages 37-63) with refractory post-surgical presumed peripherally induced dystonia (PID) were evaluated. Ultrasound-guided diagnostic nerve blocks (DNBs) localized peripheral motor nerve generators, followed by targeted cryoneurolysis. All patients achieved NRS pain reduction of 5 to 6 points with sustained motor and functional improvement over 6 to 9 months. This is the first report of DNB-guided cryoneurolysis for PID.