From the Dystonia Dialogue: Deep Brain Stimulation for Dystonia

By Jawad A. Bajwa, MD, Benjamin L. Walter, MD, and Jerrold L. Vitek, MD, PhD
Neuroscience Institute, Cleveland Clinic

Surgical therapy was first used for the treatment of dystonia over 300 years ago when Isaac Minnius sectioned one of the neck muscles in a patient with cervical dystonia in 1641. Due to technological limitations, early surgical therapies consisted mostly of procedures in which a portion of the brain thought to underlie the dystonia was destroyed. At the time there was no consensus on what areas of the brain were appropriate to treat, and the methods for locating them were rudimentary. Early reports of the effect of lesion therapy for dystonia were mixed with some surgical centers reporting great successes while others reported marked failures, with mixed results often occurring even within the same center. Improved understanding of the abnormalities in the brain that are associated with the development of dystonia along with advances in technology to identify and target these structures have led to a resurgence of surgical therapy for dystonia with less risk to the patient and more consistent improvement in symptoms. Much of this recent success has been attributed to the development of a brain pacemaker technology called deep brain stimulation or DBS.

What is DBS?

What Types of Dystonia Can DBS Improve?

Which Patients Are Eligible & What Is the Selection Process?

What Should One Expect Before & After Surgery?

What Are the Surgical Risks & Programming Side Effects?

What Other Surgical Therapies Are Available?

What Is the Difference Between DBS for Dystonia & DBS for Parkinson's Disease and Tremor?

Summary

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