Treatment of dystonic tremor syndromes, can an optimal deep brain stimulation target be identified?

In this chapter, a patient with a movement disorder comprising both tremor and dystonia will be presented. Through the chronological presentation of the case, readers learn about the caveats that come with the treatment of tremor in dystonia (TID). In this chapter, we will focus on deep brain stimulation (DBS) treatment of TID. Selection of a DBS target for patients with both tremor and dystonia is difficult, as the targets traditionally used for DBS treatment of selectively tremor or dystonia are distinct. To support the optimal treatment and target selection, our single-center results of DBS treatment for TID in a total of 13 patients will be presented, as well as a summary of published cases in literature. Furthermore, management of persisting symptoms after DBS placement, side effects, and side effect management will be discussed. After reading the chapter, readers are aware of the decision-making process for DBS treatment of TID and other complex movement disorders and know how to prioritize potential treatment effects.