gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Successful treatment of a patient with tardive dystonia with stereotactic bilateral GPI deep brain stimulation

Erfolgreiche Behandlung eines Patienten mit Tardivdystonie durch stereotaktische bilaterale GPI-Stimulation

Meeting Abstract

  • corresponding author F. Hertel - Department of Neurosurgery, Bruederkrankenhaus, Trier
  • C. Decker - Department of Neurosurgery, Bruederkrankenhaus, Trier
  • M. Züchner - Department of Neurosurgery, Bruederkrankenhaus, Trier
  • M. Pöhlau - Department of Neurology, Kamillusklinik, Asbach
  • M. Bettag - Department of Neurosurgery, Bruederkrankenhaus, Trier

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. DocP020

The electronic version of this article is the complete one and can be found online at:

Published: May 4, 2005

© 2005 Hertel et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.




To describe the case of a patient with a tardive dystonia (TD) with a clear clinical improvement after bilateral GPI - DBS.

Background:The medical treatment of tardive dystonia is difficult and often not successful. Therefore, there is a need for new therapeutic strategies. Some case reports in the literature describe the succesful tretament of TD with pallidotomy or pallidal stimulation.


We report on a 75-year-old male patient, who developed symptoms of tardive dystonia several years after the treatment of with neuroleptics for several months. He was suffering from bilateral severe disabling upperlimb dystonia, oromandibular dyskinesias, dysphagia, breathing difficulties, speech disturbance and severe blepharospasm. Before the operation, medical tretament with tiapride, tetrabenazine, trihexiphenidyl, benzodiazepines and repetitive botulinum toxine injections did not result in any significant clinical improvement. The patient underwent a bilateral stereotactic one stage stereotactic, microelectrode-guided GPI-DBS procedure under general anesthesia and CT – MRI matching. We scored the patient preoperatively, as well as 2 weeks and 3 months postoperatively by using the Burke Fahn Marsden Dystonia Rating Scale (BFMDS), the Fahn Blepharospsm Scale (FBS) and the Oromandibular Dystonia Rating Scale (ODRS). The microrecordings were carefully analysed.


Within several days, a clear clinical improvement occurred under chronic stimulation resulting in a 80% imporovement in the BFMDS (motor and disability). The Blepharospsm was also improved by 80% , whereas there was only a slow and moderate improvement of the oromandibular dyskinesias of about 50% improvement in the ODRS. (Videotape will be demonstrated) The results remained stable at a 3 month follow-up. We did not observe any neuropsychological or other significant side effects from the operation.


Our results confirm the thesis that bilateral stereotactic, microelectrode-guided GPI – DBS under general anesthesia is a safe and encouraging new therapy option in the treatment of TD.