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[Deep-brain stimulation of the internal pallidum in multiple system atrophy].

AbstractINTRODUCTION:
The experience with deep-brain stimulation (DBS) in multiple-system atrophy (MSA) is sparse and generally disappointing. DBS is currently not recommended in MSA and its use is often related to a misdiagnosis.
OBSERVATION:
We describe the outcome of bilateral DBS of the internal pallidum in a 46-year-old woman suffering from MSA that initially resembled Parkinson's disease with prominent levodopa-induced dyskinesias. DBS of the left internal pallidum was performed in 1998 after a ten-year clinical course and improved dyskinesias. Six months later, the right side was implanted. A few months after the second surgery, the patient progressively developed signs of cerebellar and dysautonomic impairment and MSA was diagnosed.
CONCLUSION:
Our observation confirms the ineffectiveness of DBS of the internal pallidum in MSA and even suggests a harmful effect. DBS remains contra-indicated in atypical parkinsonism.
AuthorsV Lambrecq, E Krim, W Meissner, D Guehl, F Tison
JournalRevue neurologique (Rev Neurol (Paris)) Vol. 164 Issue 4 Pg. 398-402 (Apr 2008) ISSN: 0035-3787 [Print] France
Vernacular TitleStimulation cérébrale profonde du pallidum interne dans l'atrophie multisystématisée.
PMID18439935 (Publication Type: Case Reports, English Abstract, Journal Article)
Topics
  • Deep Brain Stimulation (adverse effects)
  • Dyskinesias (etiology, therapy)
  • Electrodes, Implanted
  • Female
  • Globus Pallidus (physiology)
  • Humans
  • Middle Aged
  • Multiple System Atrophy (therapy)
  • Neurologic Examination
  • Neuropsychological Tests
  • Treatment Failure

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