Anesthesia management of deep brain stimulation insertion in a patient with generalized idiopathic dystonia: a case report

Dystonia is a movement disorder in which excessive muscle contractions cause abnormal movement. It is classified according to its clinical manifestations (onset, distribution, temporal and associated features) and etiology (pathology and inheritance). Deep brain stimulation (DBS) is a surgical procedure used to treat medically intractable dystonia. In this study, we aim to share our experience with general anesthesia in systemic idiopathic dystonia that was not controlled by drugs, along with a literature review. A 21-year-old man with generalized idiopathic dystonia and developmental delay was scheduled to undergo deep brain stimulator implantation under general anesthesia. Intubation of the endotracheal tube and fixation of the stereotactic frame were performed in the intensive care unit (ICU) under sedation and neuromuscular blockade before arrival at the operating room. Total intravenous anesthesia was administered. After an uneventful surgery, the patient was discharged to the ICU with an endotracheal tube. As dystonia has a wide clinical spectrum and DBS requires special anesthetic considerations, anesthesiologists should adopt proper anesthetic depth and neuromuscular blockade according to each patient's condition.