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Treatment of diaphragmatic dystonia with pallidal deep brain stimulation
  1. Shervin Rahimpour1,
  2. Nicole Calakos2,
  3. Dennis A Turner2 and
  4. Kyle T Mitchell2
  1. 1Neurosurgery, Duke University, Durham, North Carolina, USA
  2. 2Neurology, Duke University, Durham, North Carolina, USA
  1. Correspondence to Dr Shervin Rahimpour; shervin.rahimpour{at}


We present the case of a 70-year-old woman with treatment-refractory diaphragmatic dystonia. Patient initially presented with blepharospasms followed by development of involuntary inspiratory spasms during speech. Her symptoms were drug-refractory, and she therefore underwent awake bilateral pallidal deep brain stimulation with microelectrode recording. No intraoperative or postoperative complications or adverse events occurred, and there were no undesired effects of stimulation. Using contacts in bilateral dorsal globus pallidus interna and ventral globus pallidus externa, symptoms alleviated after a latency period of 2–4 weeks. At 5-month follow-up, the patient maintained a 16.5-point reduction in Burke-Fahn-Marsden movement scale (from 20/120 to 3.5/120) with resolution of blepharospasm, irregular inspirations and broken and irregular speech.

  • movement disorders (other than Parkinsons)
  • neurosurgery

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  • Contributors SR, NC, DT and KM conceived of the manuscript. All authors helped in the preparation of the manuscript draft. All authors approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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