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Dystonia

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Surgery for Dystonia

The primary goal of surgery is to reduce the motor symptoms and tremors of dystonia, as well as the side-effects that can come from some of the medications used to treat the disease.

Open Surgery. The two major brain surgical procedures for dystonia are:

Pallidotomy destroys part of the pallidus region of the brain and helps to control the symptoms that come from medication, as well involuntary muscle twisting, contracting, and repetitive movements. This surgery is also used to treat Parkinson’s disease. (Read more about Parkinson’s disease.)

Thalamotomy destroys part of the thalamus region of the brain, which can help in reduce disease symptoms like tremors and rigidity. However, the surgery poses a risk for the worsening of other symptoms such as speech and gait problems. This surgery is most effective in patients that do not have speech or gait issues.

Minimally Invasive Surgery

Deep Brain Stimulation (DBS) is a minimally invasive surgical procedure to treat neurological symptoms including those of dystonia, including tremors, rigidity, and involuntary movements. DBS uses a neurotransmitter device — similar to a heart pacemaker — to deliver electrical pulses to the exact location in the brain that generates the symptoms and blocks them. The device is connected to a wire that is implanted under the skin and runs up the length of the neck into the brain. The tip of this wire contains an electrode, which is inserted into the brain where the electrical impulses are to be delivered. These impulses block the signals in the brain that cause tremors and other symptoms.

The procedure is usually done in two stages. The first part, in which the electrode is placed in the brain, is done while the patient is awake. The patient usually stays over one night in the hospital. The second part, in which the neurotransmitters are placed under the collarbone, is very similar to that of receiving a heart pacemaker, and patients usually stay one day in the hospital.

As with all surgical procedures, DBS poses a small risk of bleeding and infection.

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Reviewed by Michael Kaplitt, M.D., Ph.D.
Last reviewed/last updated: January 2015