Adjuvant medical therapy in cervical dystonia after deep brain stimulation: A retrospective analysis

Alfonso E. Martinez-Nunez, Christos Sidiropoulos, Julia Wall, Jason Schwalb, Ellen Air, Peter LeWitt, Bisena Bulica, Patricia Kaminski, Neepa Patel

Research output: Contribution to journalArticlepeer-review

Abstract

Background: There is limited information on optimization of symptomatic management of cervical dystonia (CD) after implantation of pallidal deep brain stimulation (DBS). Objectives: To describe the long-term, “real-world” management of CD patients after DBS implantation and the role of reintroduction of pharmacologic and botulinum toxin (BoNT) therapy. Methods: A retrospective analysis of patients with focal cervical or segmental craniocervical dystonia implanted with DBS was conducted. Results: Nine patients were identified with a mean follow-up of 41.7 ± 15.7 months. All patients continued adjuvant oral medication(s) to optimize symptom control post-operatively. Three stopped BoNT and four reduced BoNT dose by an average of 22%. All patients remained on at least one medication used to treat dystonia post-operatively. Conclusion: Optimal symptom control was achieved with DBS combined with either BoNT and/or medication. We suggest utilization of adjuvant therapies such as BoNT and/or medications if DBS monotherapy does not achieve optimal symptom control.

Original languageEnglish (US)
Article number927573
JournalFrontiers in Neurology
Volume13
DOIs
StatePublished - Aug 5 2022
Externally publishedYes

Keywords

  • botulinum toxin
  • cervical dystonia
  • deep brain stimulation
  • long-term follow up
  • medical therapy

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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