Deep Brain Stimulation Surgery for Status Dystonicus: A Single-Center Experience and Literature Review. 2018

Javier Lobato-Polo, and Daniel Ospina-Delgado, and Eduardo Orrego-González, and Juan F Gómez-Castro, and Jorge L Orozco, and Alejandro Enriquez-Marulanda
Fundacion Valle del Lili, Cali, Colombia; Universidad Icesi, Cali, Colombia; Centro de Investigación Clinica, Cali, Colombia. Electronic address: jmlobatop@yahoo.com.

BACKGROUND Status dystonicus (SD) is a life-threatening complication in which episodes of dystonic movements become increasingly frequent and severe, requiring urgent hospital admission, and can lead to respiratory, metabolic, and bulbar complications. Pharmacologic treatment has been the mainstay management for this complication; however, many refractory patients will still require further treatment. Deep brain stimulation (DBS) is an established therapeutic strategy that has been used for dystonia, and now it has been proposed to be used for SD. METHODS In this case series, we describe our experience with early DBS placement in 5 patients with SD to control symptoms that are refractory to pharmacologic therapy. In addition, we present a literature review of this therapy in the treatment of SD. RESULTS Before discharge, symptomatic relief (decrease of dystonic movements and resolution of abnormal postures) was evidenced in all patients with a median of 3 days (interquartile range, 1-7) after surgery was performed. A follow-up Unified Dystonia Rating Scale score and Burke-Fahn-Marsden rating scale motor subscale score, at 6 months after hospital discharge with values being inferior to 20 and 30, respectively, for all cases. None of the patients had a recurrence of SD in the last follow-up period. CONCLUSIONS DBS surgery is a suitable, versatile, reversible and adequate therapy in the treatment of SD that is refractory to initial pharmacologic treatment.

UI MeSH Term Description Entries
D008297 Male Males
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D046690 Deep Brain Stimulation Therapy for MOVEMENT DISORDERS, especially PARKINSON DISEASE, that applies electricity via stereotactic implantation of ELECTRODES in specific areas of the BRAIN such as the THALAMUS. The electrodes are attached to a neurostimulator placed subcutaneously. Brain Stimulation, Deep,Electrical Stimulation of the Brain,Brain Stimulations, Deep,Deep Brain Stimulations,Stimulation, Deep Brain,Stimulations, Deep Brain
D020821 Dystonic Disorders Acquired and inherited conditions that feature DYSTONIA as a primary manifestation of disease. These disorders are generally divided into generalized dystonias (e.g., dystonia musculorum deformans) and focal dystonias (e.g., writer's cramp). They are also classified by patterns of inheritance and by age of onset. Familial Dystonia,Focal Dystonia,Pseudodystonia,Writer's Cramp,Adult-Onset Dystonias,Adult-Onset Idiopathic Focal Dystonias,Adult-Onset Idiopathic Torsion Dystonias,Autosomal Dominant Familial Dystonia,Autosomal Recessive Familial Dystonia,Childhood Onset Dystonias,Dystonia Disorders,Dystonia, Hereditary,Dystonia, Primary,Dystonia, Psychogenic,Dystonia, Secondary,Dystonias, Sporadic,Familial Dystonia, Autosomal Dominant,Familial Dystonia, Autosomal Recessive,Familial Dystonia, Idiopathic,Secondary Dystonia,Adult Onset Dystonias,Adult Onset Idiopathic Focal Dystonias,Adult Onset Idiopathic Torsion Dystonias,Adult-Onset Dystonia,Childhood Onset Dystonia,Dystonia Disorder,Dystonia, Adult-Onset,Dystonia, Childhood Onset,Dystonia, Familial,Dystonia, Focal,Dystonia, Idiopathic Familial,Dystonia, Sporadic,Dystonias, Adult-Onset,Dystonias, Childhood Onset,Dystonias, Familial,Dystonias, Focal,Dystonias, Hereditary,Dystonias, Idiopathic Familial,Dystonias, Primary,Dystonias, Psychogenic,Dystonias, Secondary,Dystonic Disorder,Familial Dystonias,Familial Dystonias, Idiopathic,Focal Dystonias,Hereditary Dystonia,Hereditary Dystonias,Idiopathic Familial Dystonia,Idiopathic Familial Dystonias,Primary Dystonia,Primary Dystonias,Pseudodystonias,Psychogenic Dystonia,Psychogenic Dystonias,Secondary Dystonias,Sporadic Dystonia,Sporadic Dystonias,Writer Cramp,Writers Cramp

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