Posttraumatic peripherally-induced dystonia and multifocal deep brain stimulation: case report.

Abstract

We report on the effect of multifocal deep brain stimulation for the treatment of posttraumatic peripherally-induced dystonia. 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. 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. Although deep brain stimulation is received with great enthusiasm, it is important to identify its limitations in certain subtypes of dystonia.