Movement Disorders: Dystonia

2006). Also, we on a patient affected by fixed hemidystonia who was unresponsive to Gpi DBS but not to M1 ICS (Romito et al 2007). All patients treated were refractory to conventional medical and non-invasive treatments (benzodiazepines, baclofen, motor rehabilitation, and botulinum toxin injections) and did not fulfil the Fahn and Williams’s criteria for psychogenic dystonia. All were severely disabled: 5 patients had fixed dystonia secondary to cortical or subcortical ischemic stroke; in 1 patient to birth anoxia; in 2 patients to iatrogenic post-surgical syndromes; in 1 patient to postencephalitic syndrome; in 1 patient to long-term neuroleptic treatment (tardive dystonia); and in the last patient secondary to brain trauma. A movement disorder neurologist evaluated all patients both pre-operatively and post-operatively. These evaluations confirmed the phenotypic characteristics of unilateral upper limb fixed dystonia, involving, with various degrees of severity, shoulder, arm, forearm, and hand. Polygraphic EMG recordings showed tonic muscular co-contractions in the affected muscles at rest in all patients. Extensive psychiatric examination excluded the diagnosis of psychogenic dystonia, and complex regional pain syndrome (CRPS)-associated dystonia.