Posttraumatic Peripherally-induced Dystonia and Multifocal Deep Brain Stimulation

Author:

Capelle Hans-Holger1,Grips Eva2,Weigel Ralf3,Blahak Christian2,Hansjörg Baezner2,Wohrle Johannes C.2,Krauss Joachim K.1

Affiliation:

1. Department of Neurosurgery, Hannover Medical School, Hannover, Germany (Capelle, Krauss)

2. Department of Neurology, University Hospital, Klinikum Mannheim, Mannheim, Germany (Grips, Blahak, Hansjörg, Wohrle)

3. Department of Neurosurgery, University Hospital, Klinikum Mannheim, Mannheim, Germany (Weigel)

Abstract

Abstract OBJECTIVE: We report on the effect of multifocal deep brain stimulation for the treatment of posttraumatic peripherally-induced dystonia. CLINICAL PRESENTATION: A 34-year-old woman presented with an 8-year history of painful tonic dystonia starting in her left leg after injury of the third metatarsal bone. She did not benefit from right-sided pallidal stimulation by an electrode misplaced in the globus pallidus externus in another hospital. INTERVENTION: Quadripolar deep brain stimulation electrodes were placed in the globus pallidus internus and the ventrolateral thalamus by computed tomographic-guided stereotactic surgery and microelectrode recording contralateral to the side of dystonia. The Burke-Fahn-Marsden motor score of 34 did not improve with chronic pallidal or thalamic stimulation. CONCLUSION: Although deep brain stimulation is received with great enthusiasm, it is important to identify its limitations in certain subtypes of dystonia.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Neurology (clinical),Surgery

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