Introduction: Dystonia is a movement disorder substantially affecting the quality of life. Botulinum Neurotoxin (BoNT) is used intramuscularly as a treatment for dystonia; however, not all dystonia patients respond to this treatment. Deep brain stimulation (DBS) is an established treatment for Parkinson’s disease (PD) and essential tremor, but it can help in dystonia as well. Objectives: We studied a total of 67 dystonia patients who were treated with DBS over a period of 7 years to find out the long-term efficacy of DBS in those patients. First, we calculated patient improvement in post-surgery follow-up programs using the Global Dystonia Severity scale (GDS) and Burke–Fahn–Marsden dystonia rating scale (BFMDRS). Secondly, we analyzed the scales scores to see if there was any statistical significance. Methods: In our study we analyzed patients with ages from 38 to 78 years with dystonia who underwent DBS surgery between January 2014 and December 2020 in four different centers (India, Kuwait, Egypt, and Turkey). The motor response to DBS surgery was retrospectively measured for each patient during every follow-up visit using the GDS and the BFMDRS scales. Results: Five to 7 years post-DBS, the mean reduction in the GDS score was 30 ± 1.0 and for the BFMDRS score 26 ± 1.0. The longitudinal change in scores at 12 and 24 months post-op was also significant with mean reductions in GDS and BFMDRS scores of 68 ± 1.0 and 56 ± 1.0, respectively. The p-values were <0.05 for our post-DBS dystonia patients. Conclusions: This study illustrates DBS is an established, effective treatment option for patients with different dystonias, such as generalized, cervical, and various brain pathology-induced dystonias. Although symptoms are not completely eliminated, continuous improvements are noticed throughout the post-stimulation time frame.

Background/Objectives: Epidural electrical stimulation (EES) is an investigational, off-label neuromodulation strategy used adjunctively with rehabilitation in chronic spinal cord injury (SCI), but safety and longitudinal functional data specific to traumatic cervical SCI remain limited. This is a descriptive safety-and-feasibility study, not an efficacy study; no efficacy or causal claim is made. Methods: In this single-centre observational cohort, 32 consecutive patients with traumatic cervical SCI underwent EES implantation and were included in baseline and safety analyses, while longitudinal analyses comprised the 26 participants with complete Spinal Cord Independence Measure (SCIM) III data at baseline and 3, 6, 9 and 12 months. Rehabilitation dose was quantified (approximately 1087 prescribed therapy hours over 12 months) and adverse events were classified using ISO 14155:2020 definitions with WHO–UMC causality grading. Prespecified outcomes were device- and procedure-related adverse events and total and domain-specific SCIM III scores; analyses were descriptive. Results: Patients were aged 33.8 ± 10.3 years, 28 (87.5%) were male, and baseline AIS grade was A in 31 and B in 1. Mean total SCIM III increased from 14.81 ± 8.92 at baseline to 21.77 ± 14.60, 25.12 ± 15.90, 28.23 ± 17.68 and 32.42 ± 19.45 at 3, 6, 9 and 12 months (all p < 0.001), with gains across self-care, respiration and sphincter management, and mobility; 10 of 32 patients (31.3%) improved by at least one AIS grade. Adverse events were infrequent: sterile hardware-site inflammation (2, 6.3%), explantation (1, 3.1%) and a first-ever seizure (1, 3.1%), without stimulation-related neurological deterioration. Conclusions: The cohort was highly selected (31/32 baseline AIS A; 87.5% male; injury-to-implant interval 10–339 months), no comparator group was available, stimulation programming was individualised rather than protocolised, and 6 of 32 patients lacked complete 12-month follow-up; these features limit reproducibility and generalisability and preclude any inference about effectiveness. EES with rehabilitation was well tolerated and accompanied by progressive functional gains, although the uncontrolled design precludes causal inference. The contribution of this report is therefore transparent safety, dose and programming data, together with a prespecified protocol framework intended to make a controlled, propensity-matched evaluation of EES in traumatic cervical SCI feasible and reproducible.

Spinal cord injury (SCI) may result from diverse etiologies, ranging from traumatic mechanisms to non-traumatic conditions such as spinal cord tumors. Among intramedullary spinal tumors in adults, ...