Direct relief of levodopa-induced dyskinesia by stimulation in the area above the subthalamic nucleus in a patient with Parkinson's disease--case report

Neurol Med Chir (Tokyo). 2010;50(3):257-9. doi: 10.2176/nmc.50.257.

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.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antiparkinson Agents / administration & dosage
  • Antiparkinson Agents / adverse effects*
  • Deep Brain Stimulation*
  • Dose-Response Relationship, Drug
  • Dyskinesia, Drug-Induced / therapy*
  • Female
  • Humans
  • Levodopa / administration & dosage
  • Levodopa / adverse effects*
  • Parkinson Disease / drug therapy*
  • Subthalamic Nucleus
  • Treatment Outcome

Substances

  • Antiparkinson Agents
  • Levodopa