Meige syndrome is a segmental form of dystonia. It is a disabling disease, especially when refractory to treatment with botulinum toxin. A well-established therapeutic option is deep brain stimulation (DBS), and the target in bilateral globus pallidus internus (GPi DBS) demonstrated satisfactory short- and long-term efficacy. However, some patients present minor or suboptimal responses after GPi DBS, and in those cases, rescue DBS may be appropriate. The present case illustrates a good outcome after subthalamic nucleus (STN) and not after GPi DBS (considering that both were well positioned and had adequate programming). The larger dimension of the GPi and its somatotopic organization, with the stimulation outside the “face region,” could explain our outcomes.

Keywords:
Dystonia, Meige syndrome, Stimulation, Rescue deep brain stimulation
1.
Horn
 
A
,
Kühn
 
AA
.
Lead-DBS: a toolbox for deep brain stimulation electrode localizations and visualizations
.
Neuroimage
.
2015 Feb 15
;
107
:
127
–
35
.
https://doi.org/10.1016/j.neuroimage.2014.12.002
.
Google Scholar
Crossref
Search ADS
 
2.
Pauls
 
KAM
,
Krauss
 
JK
,
Kämpfer
 
CE
,
Kühn
 
AA
,
Schrader
 
C
,
Südmeyer
 
M
,  
Causes of failure of pallidal deep brain stimulation in cases with pre-operative diagnosis of isolated dystonia
.
Parkinsonism Relat Disord
.
2017 Oct
;
43
:
38
–
48
.
https://doi.org/10.1016/j.parkreldis.2017.06.023
.
Google Scholar
Crossref
Search ADS
PubMed
 
3.
Wang
 
X
,
Mao
 
Z
,
Cui
 
Z
,
Xu
 
X
,
Pan
 
L
,
Liang
 
S
,  
Predictive factors for long-term clinical outcomes of deep brain stimulation in the treatment of primary Meige syndrome
.
J Neurosurg
.
2019 Apr 5
;
132
(
5
):
1367
–
75
.
https://doi.org/10.3171/2019.1.JNS182555
.
Google Scholar
Crossref
Search ADS
 
4.
Yao
 
C
,
Horn
 
A
,
Li
 
N
,
Lu
 
Y
,
Fu
 
Z
,
Wang
 
N
,  
Post-operative electrode location and clinical efficacy of subthalamic nucleus deep brain stimulation in Meige syndrome
.
Parkinsonism Relat Disord
.
2019 Jan
;
58
:
40
–
5
.
https://doi.org/10.1016/j.parkreldis.2018.05.014
.
Google Scholar
Crossref
Search ADS
PubMed
 
5.
Vayssiere
 
N
,
van der Gaag
 
N
,
Cif
 
L
,
Hemm
 
S
,
Verdier
 
R
,
Frerebeau
 
P
,  
Deep brain stimulation for dystonia confirming a somatotopic organization in the globus pallidus internus
.
J Neurosurg
.
2004 Aug
;
101
(
2
):
181
–
8
.
https://doi.org/10.3171/jns.2004.101.2.0181
.
Google Scholar
Crossref
Search ADS
PubMed
 
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