Combined pallidal and subthalamic nucleus stimulation in sporadic dystonia-parkinsonism
Journal of Neurosurgery, Volume 0, Issue 0, Page 1-4, Ahead of Print.
Johannes C. Wöhrle, M.D., Christian Blahak, M.D., Hans-Holger Capelle, M.D., Wolfgang Fogel, M.D., Hansjoerg Bäzner, M.D., and Joachim K. Krauss, M.D. Multifocal deep brain stimulation (DBS) is a new technique that has been introduced recently. A 39-year-old man with dystonia-parkinsonism underwent the simultaneous implantation of subthalamic nucleus (STN) and globus pallidus internus (GPi) DBS electrodes. While bilateral STN DBS controlled the parkinsonian symptoms well and allowed for a reduction in levodopa, the improvement of dystonia was only temporary. Additional GPi DBS also alleviated dystonic symptoms. Formal assessment at the 1-year follow-up showed that both the parkinsonian symptoms and the dystonia were markedly improved via continuous bilateral combined STN and GPi stimulation. Sustained benefit was achieved at 3 years postoperatively.
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