Deep-brain stimulation of the internal pallidum in multiple system atrophy | Stimulation cérébrale profonde du pallidum interne dans l’atrophie multisystématisée
Revue Neurologique. 2008-04-01; 164(4): 398-402
DOI: 10.1016/j.neurol.2008.01.004
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1. Rev Neurol (Paris). 2008 Apr;164(4):398-402. doi: 10.1016/j.neurol.2008.01.004.
Epub 2008 Mar 25.
[Deep-brain stimulation of the internal pallidum in multiple system atrophy].
[Article in French]
Lambrecq V(1), Krim E, Meissner W, Guehl D, Tison F.
Author information:
(1)Département de neurologie, groupe hospitalier sud, CHU de Bordeaux, Bordeaux,
France.
INTRODUCTION: 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.
DOI: 10.1016/j.neurol.2008.01.004
PMID: 18439935 [Indexed for MEDLINE]