Selective cervical denervation has a limited but defined role in cervical dystonia, substantiated by long-term outcomes

Cervical dystonia still presents a therapeutic challenge for neurologists and neurosurgeons both in its ‘isolated’ form, and also as a manifestation of generalised dystonia. Botulinum toxin has been firmly established as first-line treatment to be followed or complemented by surgery, either cervical rhizotomy or deep brain stimulation (DBS), predominantly of the globus pallidus internus. The pathophysiology of dystonia points to basal ganglia dysfunction. So why continue to perform destructive procedures such as rhizotomies rather than relegate such intervention to the intellectual scrap heap?

In their JNNP paper, Bergenheim et al1 report their long-term outcomes for 61 …