Long-term follow-up study on deep brain stimulation for post-traumatic dystonia

<p><strong>Background</strong> Deep brain stimulation (DBS) offers a very promising therapy for medically intractable dystonia. Among different dystonia subtypes, the surgical outcome of primary dystonia is most convincing, while that of post-traumatic dystonia is uncertain. This paper aims to evaluate the effect of DBS on post-traumatic dystonia. <strong>Methods</strong> Four patients of post-traumatic dystonia treated with DBS on globus pallidus internus (GPi) or subthalamic nucleus (STN) were reviewed and their surgical effect was evaluated. Outcome assessments were based on Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) movement and disability scores preoperatively and one month, 6 months, one year and 2 years after surgery. Improvement rate was counted to evaluate the curative effect. <strong>Results</strong> BFMDRS movement scores were improved by 38.35%, 47.28%, 62.74% and 68.69% respectively, and disability scores were improved by 35.36% , 46.83% , 59.60% and 67.01% respectively. Imaging features of these patients were reviewed. Although the location and size of encephalomalacia differed among these patients, the anatomical features of basal ganglia remained intact. <strong>Conclusions </strong>With strict selection, DBS may be a promising treatment to ameliorate the symptoms of post-traumatic dystonia. The surgical effect may be sustainable in long term. Anatomical integrity of basal ganglia may be an important factor to predict good outcome.</p><p> </p><p><strong>DOI: </strong>10.3969/j.issn.1672-6731.2015.10.006