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Review
. 2020 Dec 31:10:60.
doi: 10.5334/tohm.575.

Adductor Spasmodic Dysphonia Improves with Bilateral Thalamic Deep Brain Stimulation: Report of 3 Cases Done Asleep and Review of Literature

Virgilio Gerald H Evidente  1 , Francisco A Ponce  2 , Maris H Evidente  1 , Margaret Lambert  2 , Robin Garrett  1 , Manikandan Sugumaran  3 , David G Lott  4
Affiliations
Review

Adductor Spasmodic Dysphonia Improves with Bilateral Thalamic Deep Brain Stimulation: Report of 3 Cases Done Asleep and Review of Literature

Virgilio Gerald H Evidente et al. Tremor Other Hyperkinet Mov (N Y). .

Abstract

Background: To date, there are only six published reports of adductor spasmodic dysphonia (SD) responding to awake thalamic deep brain stimulation (DBS).

Methods: We retrospectively reviewed cases of Essential Tremor (ET) with SD that were seen in our center from 2012 to 2020. We further identified those that have undergone thalamic DBS, and had a blinded laryngologist rate first the audio voice recordings before and after DBS using the Unified Spasmodic Dysphonia Rating Scale (USDRS), and the video recordings last to rate the related movements and facial grimacing.

Results: We identified three cases of adductor SD with ET that had undergone bilateral ventralis intermedius (VIM) DBS under general anesthesia. All patients noted improvement of their limb and voice tremor, as well as their SD post-DBS. Although improvement of tremor was observed even with initial programming in all three, improvement of SD was noted only upon reaching higher amplitudes or wider pulse widths. Blinded voice assessments showed improvement of USDRS scores post-DBS compared to pre-DBS, and with stimulator on compared to stimulator off.

Discussion: We report the first three cases of SD responding favorably to bilateral VIM asleep DBS and summarize the nine cases so far of SD who have undergone thalamic DBS.

Keywords: DBS; Essential Tremor; Spasmodic dysphonia; deep brain stimulation; laryngeal dystonia; thalamic DBS.

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Conflict of interest statement

VGHE and FAP have received speaking honoraria and are consultants for Medtronic. ML is an educational consultant for Medtronic. The rest of the authors have no financial disclosures to report. None of the authors have any conflicts of interest to disclose pertinent to the current article.

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