Preoperative and Postoperative Deep Brain Stimulation Outcomes in a 42-Year-Old Man with Mobile Generalized Dystonia

This video shows a 42-year-old patient with a disease history of 3 years (L-7673). Prior to DBS, he presented with mobile generalized dystonia more pronounced on the upper half of the body with marked truncal dystonia, severe intermittent jaw opening dystonic spasms and clonic blepharospasm. One week after DBS, dystonia has remarkably improved but hypomimia and bradykinesia were now prominent, as well as more pronounced drooling. In this phase, we switched off the pulse generator resulting in a decrease of Parkinsonian signs comparable to the preoperative status. Stimulation parameters were adjusted but a compromise between dystonia reduction and deterioration of parkinsonism had to be found. This observation argues for a stimulation-induced effect in this patient in addition to underlying parkinsonism.