Case report: Pallidal deep brain stimulation for treatment of tardive dystonia/dyskinesia secondary to chronic metoclopramide medication

Objectives: Tardive 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 l...

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Main Authors: Nagel, Johanna Maria (Author) , Ghika, Joseph (Author) , Runge, Joachim (Author) , Wolf, Marc (Author) , Krauss, Joachim K. (Author)
Format: Article (Journal)
Language:English
Published: 12 January 2023
In: Frontiers in neurology
Year: 2023, Volume: 13, Pages: 1-5
ISSN:1664-2295
DOI:10.3389/fneur.2022.1076713
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.3389/fneur.2022.1076713
Verlag, kostenfrei, Volltext: https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2022.1076713/full
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Author Notes:Johanna M. Nagel, Joseph Ghika, Joachim Runge, Marc E. Wolf and Joachim K. Krauss
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Summary:Objectives: Tardive 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. Methods: We 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). Results: GPi 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). Discussion: Pallidal DBS may result in sustained improvement of TDD secondary to chronic metoclopramide intake in the long term.
Item Description:Gesehen am 16.07.2024
Physical Description:Online Resource
ISSN:1664-2295
DOI:10.3389/fneur.2022.1076713