Long-term follow-up study of chronic globus pallidus internus stimulation for posttraumatic hemidystonia - Case report

The authors report the first case of chronic globus pallidus internus (GPi) stimulation for treatment of medically intractable hemidystonia for which long-term follow-up data are available. The patient had developed left-side d low-frequency tremor and hemidystonia after a severe head trauma sustaine d at 15 years of age. He experienced relief of the tremor but not of the he midystonia after a thalamotomy was performed in the right hemisphere 3 year s postinjury. When the patient was 24 years old, the authors performed a ma gnetic resonance-guided stereotactic implantation of a monopolar electrode in the right-sided posteroventral GPi. Chronic deep brain stimulation resul ted in remarkable improvement of dystonia-associated pain, phasic dystonic movements, and dystonic posture, which was accompanied by functional gain. Postoperative improvement was sustained after 4 years of follow up. Chronic GPi stimulation appears to be a valuable treatment option for posttraumati c dystonia.