caa a22 4500 445811145 CHVBK 20180317145212.0 cr unu---uuuuu 170323e20111101xx s 000 0 eng 10.1007/s00415-011-6075-0 doi (NATIONALLICENCE)springer-10.1007/s00415-011-6075-0 Mixed results for GPi-DBS in the treatment of cranio-facial and cranio-cervical dystonia symptoms [Elektronische Daten] [Natlada Limotai, Criscely Go, Genko Oyama, Nelson Hwynn, Theresa Zesiewicz, Kelly Foote, Roongroj Bhidayasiri, Irene Malaty, Pam Zeilman, Ramon Rodriguez, Michael Okun] The aim of the study is to determine clinical outcomes in patients undergoing Globus Pallidus Internus Deep Brain Stimulation (GPi-DBS) for cranio-facial and cranio-cervical dystonia (Meige) symptoms. A total of 6 patients seen between 2002 and 2010 with cranio-facial and cranio-cervical dystonia symptoms were identified from the University of Florida Institutional Review Board approved database. Patients were videotaped using a standardized protocol, and tapes were randomized and blindly reviewed by a movement disorders neurologist. The Unified Dystonia Rating Scale improved 31.6±23.2% (range: 3.4-63.2%) at 6 months and 63.7±35.3% (range: 6.3-100%) at 12 months. The Burke-Fahn-Marsden Dystonia Rating Scale improved 45.3±29.5% (range: 4.7-75.0%) at 6 months and 61.8±30.9% (range: 16.6-100%) at 12 months. One patient significantly had a very large improvement with little evidence of residual dystonia. Blepharospasm improved in all patients, whereas speech and swallowing did not improve in this cohort. Two patients improved with unilateral GPi-DBS, although one required a contralateral DBS later in the disease course. Two patients were managed with low frequency stimulation (<100Hz). Two patients had less than 20% benefit. GPi-DBS for cranio-facial and cranio-cervical symptoms is an effective strategy to manage a subset of patients who remain unresponsive to optimized medical management. Unilateral stimulation may be an option for some patients, but it remains unclear whether response to single-sided stimulation will be sustainable. The mixed results of this GPi-DBS case series highlight the need for a careful re-examination of selection criteria, alternative brain targets, and possibly rescue leads for patients who are non-responders to the GPi target. Springer-Verlag, 2011 Pallidum nationallicence Segmental nationallicence Frequency nationallicence Outcome nationallicence Meige nationallicence Limotai Natlada Department of Neurology, Center for Movement Disorders and Neurorestoration, University of Florida, 101 S Newell Dr., L3-101, 32611, Gainesville, FL, USA aut Go Criscely Department of Neurology, Center for Movement Disorders and Neurorestoration, University of Florida, 101 S Newell Dr., L3-101, 32611, Gainesville, FL, USA aut Oyama Genko Department of Neurology, Center for Movement Disorders and Neurorestoration, University of Florida, 101 S Newell Dr., L3-101, 32611, Gainesville, FL, USA aut Hwynn Nelson Department of Neurology, Center for Movement Disorders and Neurorestoration, University of Florida, 101 S Newell Dr., L3-101, 32611, Gainesville, FL, USA aut Zesiewicz Theresa Department of Neurology, College of Medicine Tampa, University of South Florida Health, Tampa, FL, USA aut Foote Kelly Department of Neurology, Center for Movement Disorders and Neurorestoration, University of Florida, 101 S Newell Dr., L3-101, 32611, Gainesville, FL, USA aut Bhidayasiri Roongroj Chulalongkorn Comprehensive Movement Disorders Center, Chulalongkorn University Hospital, Thai Red Cross Society, Bangkok, Thailand aut Malaty Irene Department of Neurology, Center for Movement Disorders and Neurorestoration, University of Florida, 101 S Newell Dr., L3-101, 32611, Gainesville, FL, USA aut Zeilman Pam Department of Neurology, Center for Movement Disorders and Neurorestoration, University of Florida, 101 S Newell Dr., L3-101, 32611, Gainesville, FL, USA aut Rodriguez Ramon Department of Neurology, Center for Movement Disorders and Neurorestoration, University of Florida, 101 S Newell Dr., L3-101, 32611, Gainesville, FL, USA aut Okun Michael Department of Neurology, Center for Movement Disorders and Neurorestoration, University of Florida, 101 S Newell Dr., L3-101, 32611, Gainesville, FL, USA aut Journal of Neurology Springer-Verlag 258/11(2011-11-01), 2069-2074 0340-5354 258:11<2069 2011 258 415 https://doi.org/10.1007/s00415-011-6075-0 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00415-011-6075-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Limotai Natlada Department of Neurology, Center for Movement Disorders and Neurorestoration, University of Florida, 101 S Newell Dr., L3-101, 32611, Gainesville, FL, USA aut NATIONALLICENCE 700 1- Go Criscely Department of Neurology, Center for Movement Disorders and Neurorestoration, University of Florida, 101 S Newell Dr., L3-101, 32611, Gainesville, FL, USA aut NATIONALLICENCE 700 1- Oyama Genko Department of Neurology, Center for Movement Disorders and Neurorestoration, University of Florida, 101 S Newell Dr., L3-101, 32611, Gainesville, FL, USA aut NATIONALLICENCE 700 1- Hwynn Nelson Department of Neurology, Center for Movement Disorders and Neurorestoration, University of Florida, 101 S Newell Dr., L3-101, 32611, Gainesville, FL, USA aut NATIONALLICENCE 700 1- Zesiewicz Theresa Department of Neurology, College of Medicine Tampa, University of South Florida Health, Tampa, FL, USA aut NATIONALLICENCE 700 1- Foote Kelly Department of Neurology, Center for Movement Disorders and Neurorestoration, University of Florida, 101 S Newell Dr., L3-101, 32611, Gainesville, FL, USA aut NATIONALLICENCE 700 1- Bhidayasiri Roongroj Chulalongkorn Comprehensive Movement Disorders Center, Chulalongkorn University Hospital, Thai Red Cross Society, Bangkok, Thailand aut NATIONALLICENCE 700 1- Malaty Irene Department of Neurology, Center for Movement Disorders and Neurorestoration, University of Florida, 101 S Newell Dr., L3-101, 32611, Gainesville, FL, USA aut NATIONALLICENCE 700 1- Zeilman Pam Department of Neurology, Center for Movement Disorders and Neurorestoration, University of Florida, 101 S Newell Dr., L3-101, 32611, Gainesville, FL, USA aut NATIONALLICENCE 700 1- Rodriguez Ramon Department of Neurology, Center for Movement Disorders and Neurorestoration, University of Florida, 101 S Newell Dr., L3-101, 32611, Gainesville, FL, USA aut NATIONALLICENCE 700 1- Okun Michael Department of Neurology, Center for Movement Disorders and Neurorestoration, University of Florida, 101 S Newell Dr., L3-101, 32611, Gainesville, FL, USA aut NATIONALLICENCE 773 0- Journal of Neurology Springer-Verlag 258/11(2011-11-01), 2069-2074 0340-5354 258:11<2069 2011 258 415 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer