gms | German Medical Science

55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

How does dystonia recur after discontinuation of chronic deep brain stimulation?

Chronische tiefe Hirnstimulation bei Dystonie: Wiederauftreten dystoner Symptome im Zeitverlauf nach Unterbrechung der Stimulation

Meeting Abstract

  • corresponding author Hans-Holger Capelle - Department of Neurosurgery, University Hospital Mannheim, University Heidelberg, Mannheim
  • E. Grips - Department of Neurology, University Hospital Mannheim, University Heidelberg, Mannheim
  • C. Blahak - Department of Neurology, University Hospital Mannheim, University Heidelberg, Mannheim
  • H. J. Bäzner - Department of Neurology, University Hospital Mannheim, University Heidelberg, Mannheim
  • R. Weigel - Department of Neurosurgery, University Hospital Mannheim, University Heidelberg, Mannheim
  • J. C. Wöhrle - Department of Neurology, University Hospital Mannheim, University Heidelberg, Mannheim
  • J. K. Krauss - Department of Neurosurgery, University Hospital Mannheim, University Heidelberg, Mannheim

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocDI.06.02

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2004/04dgnc0203.shtml

Veröffentlicht: 23. April 2004

© 2004 Capelle et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

Chronic deep brain stimulation (DBS) for medically refractory dystonia has been recognized as a valuable treatment option only recently. The full effect of DBS may appear only after months, but in contrast to Parkinson´s Disease it is unknown how dystonic symptoms recur after discontinuation of chronic DBS.

Methods

In this prospective study we enclosed 8 patients with segmental or generalized dystonia who underwent pallidal (7 patients) or thalamic (1 patient) chronic DBS. Mean age at surgery was 47.9 years, there were 4 men and 4 women. The time course of the appearance of dystonic symptoms has been assessed at 5±2 months postoperatively according to the Burke-Fahn-Marsden (BFM) Dystonia Scale immediately and at 4 hours after switching off DBS.

Results

Seven patients benefitted from chronic DBS, while one patient had no improvement. After discontinuation of DBS, dystonic symptoms recurred within minutes in 3 patients. In one of these patients, further worsening of dystonia was observed over the next four hours. In the other 4 patients dystonic symptoms only gradually returned to baseline at 4 hours. The dystonic symptoms which reappeared early after discontinuation of DBS were primarily phasic, while those which worsened gradually were the tonic components.

Conclusions

Discontinuation of chronic DBS in patients with dystonia has a differential impact on the time course of the reappearance of phasic and tonic dystonic movements. These findings indicate that the effect of DBS on dystonic symptoms are mediated via different pathophysiological processes.