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 hemidystonia due to striatal lesions by unilateral stereotactic GPI – DBS: a report of 2 cases

Erfolgreiche Behandlung von 2 Patienten mit Hemidystonie durch striatale Läsionen mittels unilateraler GPI-Stimulation

Meeting Abstract

  • corresponding author F. Hertel - Neurochirurgische Abt., Brüderkrankenhaus, Trier
  • C. Decker - Neurochirurgische Abt., Brüderkrankenhaus, Trier
  • I. Weimar - Neurologische Abt., Brüderkrankenhaus, Trier
  • B. Rohrscheider - Neurologische Abt., Brüderkrankenhaus, Trier
  • M. Züchner - Neurochirurgische Abt., Brüderkrankenhaus, Trier
  • E. Erken - Neurologische Abt., Städtisches Klinikum Idar-Oberstein
  • R. Mandler - Neurologische Abt., Städtisches Klinikum Idar-Oberstein
  • M. Bettag - Neurochirurgische Abt., Brüderkrankenhaus, 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. DocP021

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 desribe the cases of 2 patients suffering from severe hemidystonic symptoms due to striatal lesions and their succesful treatment using bilateral GPI – DBS.

Background:Hemidystonia, due to different pathologies may be refractory to medical treatment. Despite an increasing number of publications descrinbing the results of DBS in generalized (mainly genetically determined) dystonia, there are only a few papers reporting onthe results of DBS in hemidystoniaas well as its anatomico – pathophysiological causes.


We describe the cases of a 64-year-old female and of a 58-year-old male suffering from severe hemidystonic symptoms for 8 years (female) and 6 months (male), respectively. We analysed the radiologicusing a unilateral stereotactic, microelectrode – guided GPI – DBS procedure using CT – MRI matching under local anesthesia. The microrecordings are analysed and referred to the stereotactic MRI/CT database.


Both patients showed signs of striatal fibre degeneration in the IBZM SPECT, as well as one patient (female) with an additional contralateral hemibradykinesia showed a unilateral reduction of nigral levodopa production. In both cases, we did not see a sufficient clinical benefit from medical treatment with levodopa, benzodiazepines, tiapride, tetarbenazine and trihexiphenidyl. Both patients had a clear clinical benefit from the operation, resulting in a 70 to 90% motor and disability score improvement in the BFMDS. This effect occurred within the first 2 weeks after the oepration and remained stable at a 3 month follow-up. We did not observe any significant neuropsychological, any other medical side effects through the GPI stimulation.


Unilateral GPI is effective in the treatment of hemidystonia. Pathophysiological considerations about these 2 cases are discussed.