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2010•Neurologia medico-chirurgicaOpen access

Direct Relief of Levodopa-Induced Dyskinesia by Stimulation in the Area Above the Subthalamic Nucleus in a Patient With Parkinson's Disease -Case Report-

Yasumasa Nishikawa, Kazutaka Kobayashi, Hideki Oshima, Chikashi Fukaya, Takamitu YAMAMOTO, Yoichi Katayama, Akira Ogawa, Kuniaki Ogasawara

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Abstract

A 71-year-old woman with a 25-year history of levodopa (LD)-responsive Parkinson's disease (PD) developed on-off motor fluctuation and severe peak dose dyskinesia. She underwent deep brain stimulation of the subthalamic nucleus (STN-DBS). STN-DBS induced attenuation of her cardinal PD symptoms and marked improvement of dyskinesia without reduction of LD dosage perioperatively. STN-DBS thus markedly attenuated the cardinal symptoms of PD. LD-induced dyskinesia can also be controlled via reduction of LD dosage as an indirect effect of STN-DBS. The present case provides evidence of the direct antidyskinetic effect of STN-DBS, and suggests that LD-induced dyskinesia can be inhibited by stimulation in the area above the STN.

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A 71-year-old woman with a 25-year history of levodopa (LD)-responsive Parkinson's disease (PD) developed on-off motor fluctuation and severe peak dose dyskinesia. She underwent deep brain stimulation of the subthalamic nucleus (STN-DBS). STN-DBS induced attenuation of her cardinal PD symptoms and marked improvement of dyskinesia without reduction of LD dosage perioperatively. STN-DBS thus markedly attenuated the cardinal symptoms of PD. LD-induced dyskinesia can also be controlled via reduction of LD dosage as an indirect effect of STN-DBS. The present case provides evidence of the direct antidyskinetic effect of STN-DBS, and suggests that LD-induced dyskinesia can be inhibited by stimulation in the area above the STN.

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Available abstract

A 71-year-old woman with a 25-year history of levodopa (LD)-responsive Parkinson's disease (PD) developed on-off motor fluctuation and severe peak dose dyskinesia. She underwent deep brain stimulation of the subthalamic nucleus (STN-DBS). STN-DBS induced attenuation of her cardinal PD symptoms and marked improvement of dyskinesia without reduction of LD dosage perioperatively. STN-DBS thus markedly attenuated the cardinal symptoms of PD. LD-induced dyskinesia can also be controlled via reduction of LD dosage as an indirect effect of STN-DBS. The present case provides evidence of the direct antidyskinetic effect of STN-DBS, and suggests that LD-induced dyskinesia can be inhibited by stimulation in the area above the STN.

Key concepts: Dyskinesia, Subthalamic nucleus, Deep brain stimulation, Levodopa, Parkinson's disease, Stimulation, Anesthesia, Medicine

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Direct Relief of Levodopa-Induced Dyskinesia by Stimulation in the Area Above the Subthalamic Nucleus in a Patient With Parkinson's Disease -Case Report- — Research Paper | ScholarLens