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Re-emergence of surgery for dystonia
  1. JOSEPH JANKOVIC
  1. Parkinson’s Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, 6550 Fannin, Suite 1801, Houston, Texas 77030, USA. Tel 001 713 798 5998; fax 001 713 798 6808.

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    In the paper by Ford et al (this volume, pp 472–478), the authors describe the results of an open label, retrospective study of a selective denervation for severe cervical dystonia (torticollis) in 16 patients refractory to injections with botulinum toxin type A. Using functional capacity scales they concluded that six (37.5%) patients had “a moderate or complete return of normal neck function”. Despite some improvement in 12 of 14 (85.7%) patients on the Toronto western spasmodic torticollis rating scale (TWSTRS) dystonia rating scale applied to “blinded” ratings of videotaped examinations, the surgery failed to return patients to their occupations. The results of this study are comparable with those of Krauss et al 1 who recently reported the effects of 70 intradural or extradural approaches in 46 patients with severe cervical dystonia. During a mean duration of follow up …

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