Who should consider having surgery for dystonia?

Patients should consider deep brain stimulation if they meet the following criteria:

  • - Diagnosis of primary dystonia, diagnosed by a movement disorder specialist, and after secondary causes of dystonia have been ruled out.
  • - The dystonia is severe enough to adversely affect quality of life by interfering significantly with normal activities or causing social isolation.
  • - Adequate medication trials have been unsuccessful including carbidopa/levodopa (Sinemet) and anticholinergic medications such as trihexyphenidyl (Artane) or benztropin (Cogentin). Baclofen and muscle relaxants such as clonazepam also tried prior to consideration for surgery.
  • - Dystonia affects too large a body area to be treated effectively with botulinum toxin injections (Botox), or prior attempts at injections with botulinum toxin have been unsuccessful.
  • - The patient and family understand the nature and complexity of deep brain stimulation (DBS) therapy including that the treatment is too novel to guarantee successful treatment in any individual case.