To the Editor.—
In the QUESTIONS AND ANSWERS section of The Journal,1 an inquiry was made regarding the treatment of dystonia musculorum deformans in a 30-year-old woman who had been suffering from the condition in one foot for 21 years. Although I have no quarrel with the answer as given, I wish to call attention simply to the omission of any reference to neurosurgical treatment. In intractable cases this is often helpful and, at times, almost curative. Patients who do not respond to drug treatment using muscle relaxants and to physical measures such as were properly emphasized in the answer given can often obtain significant and permanent reversal of the distressing symptoms by means of stereotaxic cryothalamectomy on the side opposite to the dystonic limb. The surgical risks are about 1% for both mortality and significant morbidity, and the overall rate of substantial improvement in experienced hands is about
Stellar S. Treatment of Dystonia Musculorum Deformans. JAMA. 1984;251(9):1162. doi:10.1001/jama.1984.03340330024013
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