Parkinson's disease, subthalamic stimulation, and selection of candidates: a pathological study.
Identifieur interne : 000C65 ( Ncbi/Checkpoint ); précédent : 000C64; suivant : 000C66Parkinson's disease, subthalamic stimulation, and selection of candidates: a pathological study.
Auteurs : Bechir Jarraya [France] ; Anne-Marie Bonnet ; Charles Duyckaerts ; Jean-Luc Houeto ; Philippe Cornu ; Jean-Jacques Hauw ; Yves Agid [France]Source :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2003.
English descriptors
- KwdEn :
- 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), Parkinson Disease (physiopathology), Parkinson Disease (therapy), Subthalamic Nucleus (physiology), Tremor (physiopathology).
- MESH :
- chemical , adverse effects : Antiparkinson Agents, Levodopa.
- diagnosis : Cognition Disorders.
- drug therapy : Parkinson Disease.
- etiology : Dyskinesia, Drug-Induced.
- instrumentation : Electric Stimulation Therapy.
- physiology : Subthalamic Nucleus.
- physiopathology : Parkinson Disease, Tremor.
- therapy : Parkinson Disease.
- Aged, Disease Progression, Fatal Outcome, Female, Humans, Neuropsychological Tests.
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.
DOI: 10.1002/mds.10607
PubMed: 14673889
Affiliations:
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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. 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