Martinez-Nunez Alfonso E, Sidiropoulos Christos, Wall Julia, Schwalb Jason, Air Ellen, LeWitt Peter, Bulica Bisena, Kaminski Patricia, Patel Neepa
Department of Neurology, Henry Ford Hospital, Detroit, MI, United States.
Department of Neurology and Ophthalmology, Michigan State University, East Lansing, MI, United States.
Front Neurol. 2022 Aug 5;13:927573. doi: 10.3389/fneur.2022.927573. eCollection 2022.
There is limited information on optimization of symptomatic management of cervical dystonia (CD) after implantation of pallidal deep brain stimulation (DBS).
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.
A retrospective analysis of patients with focal cervical or segmental craniocervical dystonia implanted with DBS was conducted.
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.
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.
关于苍白球深部脑刺激（DBS）植入术后颈肌张力障碍（CD）症状管理优化的信息有限。
描述DBS植入术后CD患者的长期“真实世界”管理以及重新引入药物和肉毒毒素（BoNT）治疗的作用。
对接受DBS植入的局灶性颈部或节段性颅颈肌张力障碍患者进行回顾性分析。
确定了9例患者，平均随访41.7±15.7个月。所有患者术后继续服用辅助口服药物以优化症状控制。3例患者停用BoNT，4例患者将BoNT剂量平均减少了22%。所有患者术后至少仍服用一种用于治疗肌张力障碍的药物。
DBS联合BoNT和/或药物可实现最佳症状控制。我们建议，如果DBS单药治疗未实现最佳症状控制，可使用BoNT和/或药物等辅助治疗。
