Ian O Bledsoe1, Kristen A Dodenhoff2, Marta San Luciano1, Monica M Volz1, Philip A Starr3,4, Leslie C Markun5, Jill L Ostrem1,4. 1. Department of Neurology University of California San Francisco, San Francisco, California, USA; Movement Disorders and Neuromodulation Center San Francisco, California USA. 2. Wake Forest University School of Medicine Winston-Salem North Carolina USA. 3. Department of Neurological Surgery University of California San Francisco San Francisco, California USA. 4. Parkinson's Disease Research, Education, and Clinical Center, San Francisco Veterans Affairs Medical Center San Francisco, California USA. 5. Department of Neurology University of California Davis Sacramento, California USA.
Abstract
BACKGROUND: The pallidum has been the preferred DBS target for dystonia, but recent studies have shown equal or greater improvement in patients implanted in the STN.1 Transient stimulation-induced dyskinesia (SID) is frequently observed when stimulating this novel target, and there are no previously published video case reports of this phenomenon. CASES: We describe in detail the SID phenomenology experienced by 4 patients who had been implanted with STN DBS for isolated dystonia. CONCLUSIONS: SID can occur in focal, segmental, axial, or generalized distribution, can resemble levodopa-induced dyskinesia choreiform or dystonic movements observed in Parkinson's disease, and is generally transient and resolves with customized DBS programming. Providers should be aware that SID can occur after STN DBS when treating isolated dystonia and not assume movements are the result of worsening or spread of the underlying dystonia.
BACKGROUND: The pallidum has been the preferred DBS target for dystonia, but recent studies have shown equal or greater improvement in patients implanted in the STN.1 Transient stimulation-induced dyskinesia (SID) is frequently observed when stimulating this novel target, and there are no previously published video case reports of this phenomenon. CASES: We describe in detail the SID phenomenology experienced by 4 patients who had been implanted with STN DBS for isolated dystonia. CONCLUSIONS: SID can occur in focal, segmental, axial, or generalized distribution, can resemble levodopa-induced dyskinesia choreiform or dystonic movements observed in Parkinson's disease, and is generally transient and resolves with customized DBS programming. Providers should be aware that SID can occur after STN DBS when treating isolated dystonia and not assume movements are the result of worsening or spread of the underlying dystonia.
Authors: Jill L Ostrem; Leslie C Markun; Graham A Glass; Caroline A Racine; Monica M Volz; Susan L Heath; Coralie de Hemptinne; Philip A Starr Journal: Parkinsonism Relat Disord Date: 2014-01-05 Impact factor: 4.891
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