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Parkinson's disease, subthalamic stimulation, and selection of candidates: A pathological study
Author(s) -
Jarraya Bechir,
Bonnet AnneMarie,
Duyckaerts Charles,
Houeto JeanLuc,
Cornu Philippe,
Hauw JeanJacques,
Agid Yves
Publication year - 2003
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.10607
Subject(s) - dysarthria , subthalamic nucleus , levodopa , deep brain stimulation , parkinson's disease , stimulation , degenerative disease , central nervous system disease , medicine , neurosurgery , pathological , disease , psychology , physical medicine and rehabilitation , surgery , neuroscience , audiology
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. © 2003 Movement Disorder Society