Deep brain therapy brings relief.

• Position: Dystonia - Deep brain stimulation therapy

Two patients, freed from the severe to disabling effects of dystonia through deep brain stimulation (DBS) therapy, continued to have symptom relief for months after their devices accidentally were fully or partly turned off, according to a report published in the journal Movement Disorders.

"Current thought is that symptoms will worsen within hours or days of device shut-off, but these two young men continued to have clinical benefit despite interruption of DBS therapy for several months," reports senior author Michele Tagliati. "To our knowledge, these two cases represent the longest duration of retained benefit in primary generalized dystonia. Moreover, when these patients' symptoms did return, severity was far milder than it was before DBS."

Dystonia causes muscles to contract, with the affected body part twisting involuntarily and symptoms ranging from mild to crippling. If drugs --which often have undesirable side effects, especially at higher doses--fail to give relief, neurosurgeons and neurologists may work together to supplement medications with deep brain stimulation, aimed at modulating abnormal nerve signals. Electrical leads are implanted in the brain--one on each side--and an electrical pulse generator is placed near the collarbone. The device is programmed with a remote, hand-held controller. Tagliati...