This is a single-center, retrospective study of dystonia patients who were referred to the DBS program between January 2014 and December 2018. Patients with other movement disorders were excluded. Demographic data, dystonia classification, regimen of BoNT as well as clinical outcomes were collected. Clinical course was documented between the referral date until the last clinic follow up.  

Sixty-seven patients were included (30 males, – 45%, mean age: 48.3±20.1 years, disease duration: 16.9±15.3 years). Generalized dystonia was the most common pattern of distribution(32%). Most of the patients received BoNT prior to DBS referral (Ona-A in 65%; Ona-A and Inco-A in 5%) for a treatment duration of 6.1±5.8 years. Thirty-three(49%) patients underwent DBS: 29(85%) targeting the globus pallidus pars interna (GPI), four (12%) the unilateral ventral intermediate nucleus(VIM). Four (6%) patients were awaiting the procedure while remaining 30 patients (45%) did not undergo DBS. The reasons for the DBS decline were: patient refusal (17, 53%), functional dystonia(6, 20%) and successful use of Abo-A(3, 10%) in patients who had failed other BoNTs.