Successful Treatment of Auricular Dystonia by Unilateral Pallidothalamic Tractotomy

BACKGROUND: Ear movement disorders are rarely reported. Although some patients may respond to botulinum toxin injections, reports on surgical treatment options remain limited. CASE REPORT: A 57-year-old woman was diagnosed with auricular dystonia, which was refractory to botulinum toxin injections. Since involuntary movement and pain were predominantly present on the right side and the patient rejected the implantation of a mechanical device, we decided to perform left pallidothalamic tractotomy. Immediately following lesioning, bilateral ear movements and right auricular pain ceased with no complications. DISCUSSION: Stereotactic neurosurgical treatment can be an alternative for auricular dystonia. HIGHLIGHTS: Ear movement disorders, such as auricular myoclonus or dystonia, are rarely reported. The present case was refractory to repetitive botulinum toxin injections and oral medications. To the best of our knowledge, this is the first case of auricular dystonia that successfully improved with stereotactic neurosurgical treatment (pallidothalamic tractotomy).