Tardive Blepharospasm May Respond to Bilateral Pallidal Deep Brain Stimulation

BACKGROUND: To date, there have been no reports of tardive blepharospasm being treated with deep brain stimulation (DBS), though there have been two reports of focal blepharospasm responding favorably to bilateral pallidal DBS. CASE: A 34 year old man with tardive blepharospasm that was refractory to oral medications as well as botulinum toxin types A and B underwent bilateral pallidal DBS under general anesthesia. He had significant improvement of his severe blepharospasm by one and half months post-DBS which was sustained at last follow-up 30 months post-DBS. The best programming parameters included pulse widths of 90–100 µsec, frequencies of 140–150 Hz, and stimulating the ventral contacts in each side. CONCLUSION: Our case represents the first report of medically refractory tardive blepharospasm responding favorably to bilateral pallidal DBS.