Deep brain stimulation for focal or segmental craniocervical dystonia in patients who have failed botulinum neurotoxin therapy - a narrative review of the literature
Please always quote using this URN: urn:nbn:de:bvb:20-opus-357707
- (1) Background: The first-line treatment for patients with focal or segmental dystonia with a craniocervical distribution is still the intramuscular injection of botulinum neurotoxin (BoNT). However, some patients experience primary or secondary treatment failure from this potential immunogenic therapy. Deep brain stimulation (DBS) may then be used as a backup strategy in this situation. (2) Methods: Here, we reviewed the current study literature to answer a specific question regarding the efficacy and safety of the use of DBS, particularly for(1) Background: The first-line treatment for patients with focal or segmental dystonia with a craniocervical distribution is still the intramuscular injection of botulinum neurotoxin (BoNT). However, some patients experience primary or secondary treatment failure from this potential immunogenic therapy. Deep brain stimulation (DBS) may then be used as a backup strategy in this situation. (2) Methods: Here, we reviewed the current study literature to answer a specific question regarding the efficacy and safety of the use of DBS, particularly for cervical dystonia (CD) and Meige syndrome (MS) in patients with documented treatment failure under BoNT. (3) Results: There are only two studies with the highest level of evidence in this area. Despite this clear limitation, in the context of the narrowly defined research question of this paper, it is possible to report 161 patients with CD or MS who were included in studies that were able to show a statistically significant reduction in dystonic symptoms using DBS. Safety and tolerability data appeared adequate. However, much of the information is based on retrospective observations. (4) Conclusions: The evidence base in this area is in need of further scientific investigation. Most importantly, more randomized, controlled and double-blind trials are needed, possibly including a head-to-head comparison of DBS and BoNT.…
Author: | Thorsten M. Odorfer, Jens Volkmann |
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URN: | urn:nbn:de:bvb:20-opus-357707 |
Document Type: | Journal article |
Faculties: | Medizinische Fakultät / Neurologische Klinik und Poliklinik |
Language: | English |
Parent Title (English): | Toxins |
ISSN: | 2072-6651 |
Year of Completion: | 2023 |
Volume: | 15 |
Issue: | 10 |
Article Number: | 606 |
Source: | Toxins (2023) 15:10, 606. https://doi.org/10.3390/toxins15100606 |
DOI: | https://doi.org/10.3390/toxins15100606 |
Dewey Decimal Classification: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
Tag: | Meige syndrome; botulinum neurotoxin; cervical dystonia; deep brain stimulation; internal globus pallidus; medication therapy failure; safety and tolerability; subthalamic nucleus; symptom control |
Release Date: | 2024/06/10 |
Year of first Publication: | 2023 |
Licence (German): | CC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International |