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

Deep brain stimulation for dystonia: Outcome at long-term follow-up (3 years or longer)

Tiefe Hirnstimulation bei dystonen Bewegungsstörungen: Langzeitbeobachtung (3 Jahre oder länger)

Meeting Abstract

  • T. J. Loher - Neurochirurgische Klinik, Universitätsklinikum Mannheim, Mannheim; Neurologische Klinik, Universität Bern, Inselspital, Bern /CH
  • A. Kaelin-Lang - Neurochirurgische Klinik, Universitätsklinikum Mannheim, Mannheim; Neurologische Klinik, Universität Bern, Inselspital, Bern /CH
  • S. Weber - Neurochirurgische Klinik, Universitätsklinikum Mannheim, Mannheim; Neurologische Klinik, Universität Bern, Inselspital, Bern /CH
  • J. M. Burgunder - Neurochirurgische Klinik, Universitätsklinikum Mannheim, Mannheim; Neurologische Klinik, Universität Bern, Inselspital, Bern /CH
  • corresponding author Joachim K. Krauss - Neurochirurgische Klinik, Universitätsklinikum Mannheim, Mannheim; Neurologische Klinik, Universität Bern, Inselspital, Bern /CH

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. DocP 11.112

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2004/04dgnc0395.shtml

Veröffentlicht: 23. April 2004

© 2004 Loher 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 treatment of medically refractory dystonia has been introduced only recently. It has been shown to yield marked improvement up to 2 years after chronic stimulation in primary dystonia. Thus far, however, data on long-term follow-up has been missing. The purpose of the present study therefore was to evaluate outcome of chronic DBS after 3 years or longer.

Methods

From 1995 until 1999, a total of 12 patients with dystonic movement disorders underwent implantation of quadripolar electrodes at the Neurochirurgische Klinik in Bern. All patients, except the first two cases, were enrolled in a prospective study protocol including assessments with the Burke-Fahn-Marsden dystonia scale, the Unified Dystonia Rating Scale and standardized videotaping. The seven patients available for recent follow-up included four patients with complex cervical dystonia (CD), and one patient each with generalized dystonia (GD), posttraumatic hemidystonia (HD), and peripherally-induced paroxysmal nonkinesigenic dystonia (PNKD). The patients with HD and PKND had secondary dystonia, while the etiology was idiopathic dystonia in the other patients. All patients underwent pallidal DBS, except the patient with PNKD who had chronic DBS of the ventrointermediate (Vim) thalamic nucleus.

Results

For complex CD, follow-up was available at 4 years (1 patient), 5 years (2), and 6 years (1). One patient had three episodes of clinical deterioration because of fractures of the electrode and the wire to the pacemaker. At the last follow-up, three patients had sustained benefit as compared to short-term outcome, whereas in one patient scores had returned almost to baseline. The other three patients had continued improvement at 3 years follow-up (GD), 7 years (HD), and 8 years (PNKD). Due to the higher energy needed for chronic DBS, replacements of batteries were performed more often as compared to patients with Parkinson´s disease.

Conclusions

Chronic DBS may loose its efficacy in individual patients in the long run. In the majority of patients, however, the beneficial effects of stimulation are maintained.