Bilateral deep brain stimulation of subthalamic nucleus alleviates tardive dystonia

Abstract

Tardive dystonia (TD) can result from treatment with dopamine receptor antagonists. In the majority of patients, TD is nonremitting and causes chronic disability.1 Current treatments for TD are mainly pharmaceutical, with only limited benefit. Botulinum toxin remains the most effective treatment.2 Surgical treatment has been reported but with variable results.3–5 Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an effective treatment for off-state dystonia in Parkinson disease (PD).6 STN stimulation has also been reported effective in non-PD patients with cervical dystonia.7 Herein, we present the result of bilateral STN DBS in a young man with a 21-year history of TD. A good response to bilateral STN DBS was observed immediately and through 12-month follow-up. A 36-year-old man initially presented to our clinic in April 2003. His medical history was unremarkable until 1979, when he developed marked hallucinations and paranoia and began taking a neuroleptic agent (sulpiride 400 mg/day) to control psychotic symptoms. After 3 years of continuous treatment, he developed dystonia in the oromandibular and cervical regions …