BACKGROUND: Mutations in TUBB4A are associated with a wide phenotypic spectrum 
including generalized dystonia with whispering dysphonia (DYT-TUBB4A).
METHODS: We report the case of a 44-year-old patient with DYT-TUBB4A with a 
clinical presentation of disabling progressive dystonia, with a prominent 
laryngeal, cervical and facial involvement.
RESULTS: Bipallidal deep brain stimulation (DBS) resulted in a 55% reduction of 
dystonia severity assessed by the Burke-Fahn-Marsden scale score 6 months after 
surgery. The effect was obvious on the cervical and facial components of 
dystonia.
CONCLUSION: We suggest that bipallidal DBS should be considered in patients with 
disabling dystonia related to TUBB4A variants.