Eight-years failure of subthalamic stimulation rescued by globus pallidus implant

Abstract

Background: Deep brain stimulation is the surgical procedure of choice in patients with Parkinson's disease. The subthalamic nucleus and the globus pallidus interna are the two most common targets used to treat Parkinson's disease.

Methods: We describe three patients with previous effective subthalamic deep brain stimulation in whom globus pallidus interna deep brain stimulation was performed as "rescue" surgery, 8 years after the original operation.

Results: Two years after globus pallidus surgery the reduction of dystonia and dyskinesias led to an improvement of motor symptoms. In two patients, painful dystonias disappeared and motor fluctuations markedly improved. One patient achieved an improvement in freezing.

Conclusion: After 24 months of follow up, our observations suggest that globus pallidus deep brain stimulation, can improve motor fluctuations, dyskinesia and axial symptoms.

Keywords: Deep brain stimulation; Globus pallidus interna; Parkinson's disease; Subthalamic nucleus.