Adverse effects of subthalamic nucleus DBS in a patient with multiple system atrophy.
A 59-year-old woman with levodopa-responsive parkinsonism complicated by motor fluctuations and generalized levodopa dyskinesia underwent bilateral subthalamic deep brain stimulation (STN DBS) 7 years after symptom onset. DBS improved levodopa-responsive upper extremity bradykinesia but aggravated speech, swallowing, and gait. Motor fluctuations were not improved and levodopa dose remained unchanged. Pulse generators were turned off. Clinical features and brain MRI in this case were indicative of multiple system atrophy (MSA). STN DBS is not recommended for patients with MSA.
Tarsy
Daniel
D
Department of Neurology, Division of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA. dtarsy@bidmc.harvard.edu
Apetauerova
Diana
D
Ryan
Patricia
P
Norregaard
Thorkild
T
D000978:Antiparkinson Agents / Q000627:therapeutic use; D001284:Atrophy; D002230:Carbidopa / Q000008:administration & dosage / Q000627:therapeutic use; D003131:Combined Modality Therapy; D000075202:Contraindications; D003680:Deglutition Disorders / Q000209:etiology*; D003937:Diagnosis, Differential; D004401:Dysarthria / Q000209:etiology*; D004599:Electric Stimulation Therapy / Q000009:adverse effects*; D004567:Electrodes, Implanted; D005260:Female; D006801:Humans; D007980:Levodopa / Q000008:administration & dosage / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008839:Microelectrodes; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D010300:Parkinson Disease / Q000175:diagnosis; D011149:Pons / Q000473:pathology; D011699:Putamen / Q000473:pathology; D020531:Subthalamic Nucleus / Q000503:physiopathology*
D000978:Antiparkinson Agents; D007980:Levodopa; D002230:Carbidopa