Quiz Form

Question Date: 01/11/2023

Question: A 24-year-old man with DYT1 dystonia has become effectively disabled over the past 4 years. His dystonia was initially controlled with targeted botulinum toxin injections and various oral medications, but over the past 4 years, these treatments have become less effective and his dystonia has continued to generalize. He is no longer ambulatory and has recently developed decubitus ulcers in his buttock region. He is considering surgery<br><br>Which of the following surgical targets is most appropriate for deep brain stimulation?

Options:

• Ventro-lateral thalamus
• Globus pallidus internus
• Putamen
• Subthalamic nucleus

Correct Answer: Globus pallidus internus

Explaination: Deep brain stimulation (DBS) of the globus pallidus internus has been successfully used to treat cases of medication-refractory isolated generalized and segmental dystonia. The globus pallidus internus is the output nucleus of the basal ganglia. DBS of the subthalamic nucleus is effective in Parkinson disease. The other targets listed, including the caudate nucleus, putamen, and thalamus, are not established as effective targets for DBS in the treatment of dystonia

Reference: Morgante F, Klein C. Dystonia. Continuum (Minneap Minn). 2013 Oct19(5 Movement Disorders)1225-41. doi 10.121201.CON.0000436154.08791.67. PMID 24092288.