Treatment of Dystonia – DBS

  Qin had involuntary movements of the mouth and lower jaw and neck for 20 years, and they were progressively worse. Involuntary movements of the head and neck were manifested by nodding-like, rhythmic shaking and spasmodic contraction of the muscles of the mouth and lower jaw, with movements as pronounced when speaking. The lower jaw is right-sided, the cheeks are puffed out, and there is difficulty in showing the teeth. Involuntary contractions of the neck muscles were seen to drive the head movement. He was diagnosed as “dystonia” after going to the hospital for examination.  After admission, Qin and his family were willing to try deep brain electrical stimulation therapy. Due to sinus bradycardia, a temporary cardiac pacemaker was implanted before surgery. Then, stereotactic bilateral deep brain electrical stimulation implantation was performed under general anesthesia. The operation went smoothly, and Qin recovered well after the operation, with good healing of the incision and no special discomfort.  Qin had been suffering from dystonia for 20 years and had not been treated effectively, then he tried deep brain electrical stimulation therapy and recovered well after surgery. It can be seen that DBS surgery is able to cure dystonia.  Dystonia is a group of clinical syndromes characterized by persistent muscle contraction leading to distortions, repetitive movements or postural abnormalities. It can also manifest as abnormal activity during active movement, involving contraction of muscles unrelated to the intended movement.  What is dystonia? Dystonia is defined as a movement disorder lesion characterized by persistent or intermittent muscle contractions that can cause abnormal movements or/and postures, often repetitive dystonic movements generally with a pattern of twisting movements and may be tremulous in nature. Dystonia is often initiated or exacerbated by random movements and is accompanied by overflowing muscle activation. In most cases, dystonia has both abnormal movements and abnormal posture.  What is the treatment for dystonia Currently, the main method of DBS for dystonia is bilateral DBS-Gpi, which means that the surgical target is the medial part of the pallidum (Gpi). Clinical studies have confirmed that high-frequency electrical stimulation of the pallidum bulb is effective in improving motor dysfunction and improving the quality of life of patients with primary, generalized, and segmental dystonia,” said Prof. Xuelian Wang. The results of several long-term observational studies support the use of deep brain electrical stimulation of the pallidum bulb as a first-line treatment option for patients with dystonia in whom pharmacological treatment is not effective.”