Parkinson's disease, subthalamic stimulation, and selection of candidates: a pathological study.

Abstract

We report on a patient with Parkinson's disease (PD) who was moderately improved by stimulation of the subthalamic nucleus (STN) and died 2 years after electrode implantation. After neurosurgery, symptoms that had responded to levodopa treatment preoperatively continued to improve. Postural instability, dysarthria, and cognitive impairment continued to worsen, despite STN stimulation and levodopa treatment. Postmortem examination of the brain confirmed the diagnosis of PD and showed that the electrodes had been correctly positioned within the STN. The failure of STN stimulation in this patient confirms the importance of screening and excluding patients from surgery with evolving parkinsonian axial symptoms or cognitive impairment.

• Authors: Bechir Jarraya, Anne-Marie Bonnet, Charles Duyckaerts, Jean-Luc Houeto, Philippe Cornu, Jean-Jacques Hauw, Yves Agid
• Journal: Movement disorders : official journal of the Movement Disorder Society (Mov Disord) Vol. 18 Issue 12 Pg. 1517-20 (Dec 2003) ISSN: 0885-3185 [Print] United States
• PMID: 14673889 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright 2003 Movement Disorder Society

Chemical References

• Antiparkinson Agents
• Levodopa

Topics

• Aged
• Antiparkinson Agents (adverse effects)
• Cognition Disorders (diagnosis)
• Disease Progression
• Dyskinesia, Drug-Induced (etiology)
• Electric Stimulation Therapy (instrumentation)
• Fatal Outcome
• Female
• Humans
• Levodopa (adverse effects)
• Neuropsychological Tests
• Parkinson Disease (drug therapy, physiopathology, therapy)
• Subthalamic Nucleus (physiology)
• Tremor (physiopathology)