Transient disabling dyskinesias: a predictor of good outcome in subthalamic nucleus deep brain stimulation in Parkinson's disease

Eur Neurol. 2009;61(2):94-9. doi: 10.1159/000177941. Epub 2008 Nov 28.

Abstract

We report 5 of 75 (6.6%) patients with Parkinson's disease (PD) submitted to subthalamic nucleus deep brain stimulation (STN-DBS) who developed transient disabling dyskinesias immediately after surgery. Dyskinesias persisted despite levodopa withdrawal, cessation or reduction of stimulation, and resolved spontaneously in a maximum period of 12 weeks without the need to change stimulation active contact. Compared to the rest of our PD patients submitted to STN-DBS, the dyskinesia group needed a lower levodopa-equivalent daily dosage (LEDD) over the time of follow-up. A microlesion in the STN, probably concealed in cerebral MRI by the electrode-related artifact, could have been involved in the etiopathology of our patients' symptoms. The presence of transient disabling dyskinesia in PD patients immediately after STN-DBS might be a predictor of good outcome as measured by a decrease in the LEDD needed.

MeSH terms

  • Adult
  • Antiparkinson Agents / therapeutic use
  • Brain / diagnostic imaging
  • Brain / pathology
  • Brain / surgery
  • Deep Brain Stimulation*
  • Dyskinesias / etiology*
  • Humans
  • Levodopa / therapeutic use
  • Magnetic Resonance Imaging
  • Middle Aged
  • Parkinson Disease / drug therapy
  • Parkinson Disease / surgery*
  • Radiography
  • Retrospective Studies
  • Subthalamic Nucleus / pathology
  • Subthalamic Nucleus / physiopathology*
  • Treatment Outcome

Substances

  • Antiparkinson Agents
  • Levodopa