2012 Symposium Guest Speakers

Jill Ostrem, M.D.

Assistant Professor of Neurology in the UCSF School of Medicine

Dr. Jill Ostrem specializes in the medical and surgical treatments of movement disorders, such as Parkinson’s disease, essential tremor and dystonia. She is particularly interested in treatments such as deep brain stimulation and gene therapy as well as the use of neurotoxins such as botulinum toxin therapy.

Dr. Ostrem earned a medical degree at George Washington University in Washington, D.C. and completed a residency in neurology and a fellowship in movement disorders at UCLA Medical Center. She is an assistant professor of neurology in the UCSF School of Medicine and a member of the American Academy of Neurology and the Movement Disorders Society and the America Neurological Association.

Brief Summary of Presentation

Most patients with cervical dystonia can get relief of their symptoms with botulinum toxin (botox) injections or oral medications. There is a subset of patients, however, who still experience significant pain and disability despite these medical interventions. For these patients, deep brain stimulation may be an option to consider. Deep brain stimulation (DBS) is a surgical treatment involving implantation of a medical device or “brain pacemaker” which sends electrical impulses to specific areas in the brain to modify abnormal neuronal activity. This device-based therapy is adjustable and does not result in any permanent tissue destruction as is the case with lesion-based surgical approaches. There is now multiple controlled trial demonstrating the effectiveness of DBS in the treatment of cervical dystonia both in the short term and in  long term follow-up. Traditionally the globus pallidus (GPi) has been that brain target of stimulation, but recently another brain target has also been shown to be helpful, the subthalamic nucleus (STN). The talk will discuss DBS, patient candidacy, expected outcomes and the limitations of surgery, and what is known about the different brain targets for stimulation in patients with cervical dystonia.