OBJECTIVE: We report on the effect of multifocal deep brain stimulation for the treatment of posttraumatic peripherally-induced dystonia. CLINICAL PRESENTATION: A 34-year-old woman presented with an 8-year history of painful tonic dystonia starting in her left leg after injury of the third metatarsal bone. She did not benefit from right-sided pallidal stimulation by an electrode misplaced in the globus pallidus externus in another hospital. INTERVENTION: Quadripolar deep brain stimulation electrodes were placed in the globus pallidus internus and the ventrolateral thalamus by computed tomographic-guided stereotactic surgery and microelectrode recording contralateral to the side of dystonia. The Burke-Fahn-Marsden motor score of 34 did not improve with chronic pallidal or thalamic stimulation. CONCLUSION: Although deep brain stimulation is received with great enthusiasm, it is important to identify its limitations in certain subtypes of dystonia.
OBJECTIVE: We report on the effect of multifocal deep brain stimulation for the treatment of posttraumatic peripherally-induced dystonia. CLINICAL PRESENTATION: A 34-year-old woman presented with an 8-year history of painful tonic dystonia starting in her left leg after injury of the third metatarsal bone. She did not benefit from right-sided pallidal stimulation by an electrode misplaced in the globus pallidus externus in another hospital. INTERVENTION: Quadripolar deep brain stimulation electrodes were placed in the globus pallidus internus and the ventrolateral thalamus by computed tomographic-guided stereotactic surgery and microelectrode recording contralateral to the side of dystonia. The Burke-Fahn-Marsden motor score of 34 did not improve with chronic pallidal or thalamic stimulation. CONCLUSION: Although deep brain stimulation is received with great enthusiasm, it is important to identify its limitations in certain subtypes of dystonia.