{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T01:25:25Z","timestamp":1794014725664,"version":"4.8.0"},"reference-count":45,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,1]]},"abstract":"\n OBJECTIVE<\/jats:title>\n First-line pharmacological therapies have shown limited efficacy in status dystonicus (SD), while surgery is increasingly reported as remediable in refractory cases. In this context, there is no evidence regarding which neurosurgical approach is the safest and most effective. The aim of this study was to assess the clinical outcomes and surgery-related complications of globus pallidus internus deep brain stimulation (GPi DBS) and pallidotomy for the treatment of drug-resistant SD.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n The authors reviewed the records of patients with drug-resistant SD who had undergone GPi DBS or pallidotomy at their institution between 2003 and 2017. The severity of the dystonia was evaluated using the Barry-Albright Dystonia (BAD) Scale. Surgical procedures were performed bilaterally in all cases.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Fourteen patients were eligible for inclusion in the study. After surgery, the mean follow-up was 40.6 \u00b1 30 months. DBS ended the dystonic storm in 87.5% of cases (7\/8), while pallidotomy had a success rate of 83.3% (5\/6). No significant differences were observed between the two techniques in terms of failure rates (risk difference DBS vs pallidotomy \u22120.03, 95% CI \u22120.36 to 0.30), SD mean resolution time (DBS 34.8 \u00b1 19 days, pallidotomy 21.8 \u00b1 20.2 days, p > 0.05), or BAD scores at each postoperative follow-up (p > 0.05). The long-term hardware complication rate after DBS was 37.5%, whereas no surgery-related complications were noted following pallidotomy.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n The study data suggest that DBS and pallidotomy are equally safe and effective therapies for drug-resistant SD. The choice between the two techniques should be tailored on a case-by-case basis, depending on factors such as the etiology and evolution pattern of the underlying dystonia and the clinical conditions at the moment of SD onset. Given the limitation of the low statistical power of this study, further multicentric investigations are needed to confirm its findings.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2019.10.jns191691","type":"journal-article","created":{"date-parts":[[2019,12,27]],"date-time":"2019-12-27T20:46:43Z","timestamp":1577479603000},"page":"197-207","source":"Crossref","is-referenced-by-count":25,"title":["Deep brain stimulation versus pallidotomy for status dystonicus: a single-center case series"],"prefix":"10.3171","volume":"134","author":[{"given":"Vincenzo","family":"Levi","sequence":"first","affiliation":[{"name":"Neurosurgery Department, Functional Neurosurgery Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta;"},{"name":"Department of Electronics, Information and Bioengineering, Polytechnic University of Milan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna","family":"Zorzi","sequence":"additional","affiliation":[{"name":"Pediatric Neuroscience Department, Child Neuropsychiatry Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Messina","sequence":"additional","affiliation":[{"name":"Neurosurgery Department, Functional Neurosurgery Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Romito","sequence":"additional","affiliation":[{"name":"Neurology Department, Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Tramacere","sequence":"additional","affiliation":[{"name":"Department of Research and Clinical Development, Scientific Directorate, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivano","family":"Dones","sequence":"additional","affiliation":[{"name":"Neurosurgery Department, Functional Neurosurgery Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nardo","family":"Nardocci","sequence":"additional","affiliation":[{"name":"Pediatric Neuroscience Department, Child Neuropsychiatry Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo","family":"Franzini","sequence":"additional","affiliation":[{"name":"Neurosurgery Department, Functional Neurosurgery Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Dev Med Child Neurol","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1111\/dmcn.12339","article-title":"Status dystonicus: a practice guide","volume":"56","author":"Allen NM","year":"2014","unstructured":"Allen NM, Lin JP, Lynch T, King MD: Status dystonicus: a practice guide. 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