Bilateral pallidal deep brain stimulation for cervical and truncal dystonia

We describe a patient with idiopathic cervical and truncal dystonia refractory to medical treatment who was a poor candidate for a peripheral denervation procedure as well as the results of bilateral pallidal deep brain stimulation (DBS) implant. A 61-year-old right-handed man had a 10-year history of progressive disabling torticollis. He reported a history of trauma to the head and neck 4 years before the onset of symptoms, when a coworker boiler operator dropped a heavy bag of water on his head. His symptoms initially consisted of mild, intermittent abrupt jerking of his head and neck to the right side with any startling noise. Thereafter, this became more constant and exaggerated, presenting at the time of examination a sustained 50-degree right laterocollis, which he was able to actively reduce by 10 degrees. His chin was tonically rotated 40 degrees to the left, associated with mild anterocollis. The right shoulder was tonically elevated, touching …