**4. Deep brain stimulation**

Deep brain stimulation may also be indicated in patient that are not responsive to ITB therapy [19]. Electrodes are placed in the basal ganglia and connected to an implanted pulse generator. Basal ganglia and thalamocortical network modulation are targeted. The stimulation can be unilateral or bilateral [9]. In a study targeting internal globus pallidus, there was 33% reduction in dystonia measures at one-year follow-up [20]. Parkinson disease and congenital dystonia are 2 movement disorders with very good outcomes from DBS. Acquired dystonias, from CP and after brain injury, are very heterogeneous lesions, isolated excellent results have been obtained

with DBS in those cases, but criteria for patient selection remain uncertain [9]. DBS is reserved for patients with significant functional limitations who failed all other interventions for severe generalized dystonia [21–23].
