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Abstract Details

Real-World Outcomes of the use of Deep Brain Stimulation for the Treatment of Cervical Dystonia: A Single-Center Experience.
Movement Disorders
Movement Disorders Posters (7:00 AM-5:00 PM)
116
To describe the long-term outcomes of deep brain stimulation in patients with cervical dystonia.
Deep brain stimulation (DBS) of the globus pallidus interna (GPi) has been reported to be an effective second-line therapy for the treatment of cervical dystonia which is refractory to botulinum toxin (BoTN) or oral medication therapies.  There are few studies that look at the long-term outcomes of DBS therapy in CD beyond 48 months with variable outcomes; however all these studies only evaluated the use of DBS as monotherapy with a poor description of need for adjuvant pharmacologic therapy to achieve symptom control. 
A retrospective chart review of patients with isolated focal or segmental CD treated with DBS was identified from the Henry Ford Movement Disorders clinic database. Data on demographic, programing parameters, duration of therapy, and adjuvant treatment before and after DBS was collected, as well as pre-op and latest follow-up Toronto Western Spasmodic Torticollis Rating Scale.
Out of 9 patients (66% females), 7 had isolated CD and 2 had segmental dystonia of which 4 had torticollis, 4 laterocollis, and 1 with retrocollis. Reasons for undergoing DBS were lack of efficacy of BoTN to control symptoms (88%) and partial (11%) or complete (11%) immunity to BoTN.  The average time from onset of symptoms to DBS surgery was 11±8.79 years with an average follow up of 49.25±6.13 months post-surgery. 100% of patients required adjuvant treatment therapies to achieve optimal symptom control (anticholinergics 44%, muscle relaxants 33%, benzodiazepines 77%). From those, 66% required lower doses of adjuvant medication (average reduction was 22±13.8%) and 77% were able to decrease or stop BoTN injections.  
In our experience, optimization of CD symptoms may be achieved with a combination of DBS, BoTN and adjuvant oral medications.
Authors/Disclosures
Alfonso Enrique Martinez Nunez, MD (University of Florida - Fixel Institute)
PRESENTER 		Dr. Martinez Nunez has nothing to disclose.
Neepa J. Patel, MD, FÂ鶹´«Ã½Ó³»­ (Rush University Medical Center) Dr. Patel has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie Pharmaceuticals. Dr. Patel has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Amneal Pharmaceuticals. Dr. Patel has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Supernius Pharmaceuticals. Dr. Patel has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Boston Scientific.