Longterm Improvement After Cessation of Chronic Deep Brain Stimulation in Acquired Dystonia

Introduction: Deep brain stimulation (DBS) has become an accepted treatment for inherited and idiopathic dystonia but less so for acquired dystonia. Patients benefit from long-term improvement with chronic DBS. Prolonged benefit over months has even been reported after cessation of stimulation on long-term follow-up.

Case report: We report a case of a 25-year-old man with acquired dystonia who had sustained symptom improvement despite battery depletion after 6.5 years of chronic bilateral thalamic and pallidal DBS.

Discussion: We posit that chronic pallidal DBS can be a genuine disease-modifying treatment in single patients with dystonia with regard to its long-term effect even after prolonged discontinuation.

Highlights:

Chronic deep brain stimulation (DBS) is an approved treatment for idiopathic and inherited dystonia. During the early course of chronic stimulation, cessation of DBS due to battery depletion results in rapid worsening of symptoms and rapid battery replacement is required. Few reports of sustained symptom relief in idiopathic dystonia have been published. We report a case of sustained symptom relief in acquired dystonia after DBS cessation which likely reflects neuroplasticity changes with a disease-modifying impact.