Case report: Pallidal deep brain stimulation for treatment of tardive dystonia/dyskinesia secondary to chronic metoclopramide medication
ObjectivesTardive dystonia/dyskinesia (TDD) occurs as a side effect of anti-dopaminergic drugs, including metoclopramide, and is often refractory to medication. While pallidal deep brain stimulation (DBS) has become an accepted treatment for TDD secondary to neuroleptic medication, there is much les...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-01-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2022.1076713/full |
| _version_ | 1797955390390927360 |
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| author | Johanna M. Nagel Joseph Ghika Joachim Runge Marc E. Wolf Marc E. Wolf Joachim K. Krauss |
| author_facet | Johanna M. Nagel Joseph Ghika Joachim Runge Marc E. Wolf Marc E. Wolf Joachim K. Krauss |
| author_sort | Johanna M. Nagel |
| collection | DOAJ |
| description | ObjectivesTardive dystonia/dyskinesia (TDD) occurs as a side effect of anti-dopaminergic drugs, including metoclopramide, and is often refractory to medication. While pallidal deep brain stimulation (DBS) has become an accepted treatment for TDD secondary to neuroleptic medication, there is much less knowledge about its effects on metoclopramide-induced TDD.MethodsWe present the case of a woman with metoclopramide-induced TDD, whose symptoms were initially misjudged as “functional.” After 8 years of ineffective medical treatments, she received bilateral implantation of quadripolar electrodes into the posteroventral lateral globus pallidus internus (GPi).ResultsGPi DBS led to significant symptom reduction [Burke–Fahn–Marsden Dystonia Rating Scale (BFMDRS) motor score 24/44 at admission and 7/44 at discharge]. Chronic stimulation led to full recovery from TDD symptoms 9 years after surgery. The BFMDRS motor score decreased to 0.5 (98% improvement).DiscussionPallidal DBS may result in sustained improvement of TDD secondary to chronic metoclopramide intake in the long term. |
| first_indexed | 2024-04-10T23:32:22Z |
| format | Article |
| id | doaj.art-f82c521350524da286b1ac936e93c93e |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-10T23:32:22Z |
| publishDate | 2023-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-f82c521350524da286b1ac936e93c93e2023-01-12T05:12:06ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-01-011310.3389/fneur.2022.10767131076713Case report: Pallidal deep brain stimulation for treatment of tardive dystonia/dyskinesia secondary to chronic metoclopramide medicationJohanna M. Nagel0Joseph Ghika1Joachim Runge2Marc E. Wolf3Marc E. Wolf4Joachim K. Krauss5Department of Neurosurgery, Hannover Medical School, Hannover, GermanyService de Neurologie, Hôpital du Valais, Sion, SwitzerlandDepartment of Neurosurgery, Hannover Medical School, Hannover, GermanyDepartment of Neurology, Neurozentrum, Klinikum Stuttgart, Stuttgart, GermanyDepartment of Neurology, Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, GermanyDepartment of Neurosurgery, Hannover Medical School, Hannover, GermanyObjectivesTardive dystonia/dyskinesia (TDD) occurs as a side effect of anti-dopaminergic drugs, including metoclopramide, and is often refractory to medication. While pallidal deep brain stimulation (DBS) has become an accepted treatment for TDD secondary to neuroleptic medication, there is much less knowledge about its effects on metoclopramide-induced TDD.MethodsWe present the case of a woman with metoclopramide-induced TDD, whose symptoms were initially misjudged as “functional.” After 8 years of ineffective medical treatments, she received bilateral implantation of quadripolar electrodes into the posteroventral lateral globus pallidus internus (GPi).ResultsGPi DBS led to significant symptom reduction [Burke–Fahn–Marsden Dystonia Rating Scale (BFMDRS) motor score 24/44 at admission and 7/44 at discharge]. Chronic stimulation led to full recovery from TDD symptoms 9 years after surgery. The BFMDRS motor score decreased to 0.5 (98% improvement).DiscussionPallidal DBS may result in sustained improvement of TDD secondary to chronic metoclopramide intake in the long term.https://www.frontiersin.org/articles/10.3389/fneur.2022.1076713/fullpallidal DBSmetoclopramidetardive dystoniatardive dyskinesiaGPi DBScase report |
| spellingShingle | Johanna M. Nagel Joseph Ghika Joachim Runge Marc E. Wolf Marc E. Wolf Joachim K. Krauss Case report: Pallidal deep brain stimulation for treatment of tardive dystonia/dyskinesia secondary to chronic metoclopramide medication Frontiers in Neurology pallidal DBS metoclopramide tardive dystonia tardive dyskinesia GPi DBS case report |
| title | Case report: Pallidal deep brain stimulation for treatment of tardive dystonia/dyskinesia secondary to chronic metoclopramide medication |
| title_full | Case report: Pallidal deep brain stimulation for treatment of tardive dystonia/dyskinesia secondary to chronic metoclopramide medication |
| title_fullStr | Case report: Pallidal deep brain stimulation for treatment of tardive dystonia/dyskinesia secondary to chronic metoclopramide medication |
| title_full_unstemmed | Case report: Pallidal deep brain stimulation for treatment of tardive dystonia/dyskinesia secondary to chronic metoclopramide medication |
| title_short | Case report: Pallidal deep brain stimulation for treatment of tardive dystonia/dyskinesia secondary to chronic metoclopramide medication |
| title_sort | case report pallidal deep brain stimulation for treatment of tardive dystonia dyskinesia secondary to chronic metoclopramide medication |
| topic | pallidal DBS metoclopramide tardive dystonia tardive dyskinesia GPi DBS case report |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2022.1076713/full |
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