AUTHOR=Martinez-Nunez Alfonso E. , Sidiropoulos Christos , Wall Julia , Schwalb Jason , Air Ellen , LeWitt Peter , Bulica Bisena , Kaminski Patricia , Patel Neepa 

TITLE=Adjuvant medical therapy in cervical dystonia after deep brain stimulation: A retrospective analysis

JOURNAL=Frontiers in Neurology

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2022.927573

DOI=10.3389/fneur.2022.927573

ISSN=1664-2295

ABSTRACT=<sec><title>Background</title><p>There is limited information on optimization of symptomatic management of cervical dystonia (CD) after implantation of pallidal deep brain stimulation (DBS).</p></sec><sec><title>Objectives</title><p>To describe the long-term, “real-world” management of CD patients after DBS implantation and the role of reintroduction of pharmacologic and botulinum toxin (BoNT) therapy.</p></sec><sec><title>Methods</title><p>A retrospective analysis of patients with focal cervical or segmental craniocervical dystonia implanted with DBS was conducted.</p></sec><sec><title>Results</title><p>Nine patients were identified with a mean follow-up of 41.7 ± 15.7 months. All patients continued adjuvant oral medication(s) to optimize symptom control post-operatively. Three stopped BoNT and four reduced BoNT dose by an average of 22%. All patients remained on at least one medication used to treat dystonia post-operatively.</p></sec><sec><title>Conclusion</title><p>Optimal symptom control was achieved with DBS combined with either BoNT and/or medication. We suggest utilization of adjuvant therapies such as BoNT and/or medications if DBS monotherapy does not achieve optimal symptom control.</p></sec>