title: Subthalamic stimulation in Parkinson disease: with or without anesthesia?
abstract: OBJECTIVE
  To study the effects of general anesthesia on the postoperative outcome of patients with Parkinson disease (PD) who underwent surgery using bilateral placement of stimulating electrodes within the subthalamic nucleus (STN).
  
  
  METHODS
  Retrospective analysis.
  
  
  METHODS
  Hôpital de la Salpêtrière, Paris, France.
  
  
  METHODS
  Fifteen PD patients who underwent bilateral implantation of electrodes within the STN received general anesthesia because of severe anxiety, poorly tolerated off-period dystonia, or respiratory difficulties. These patients were compared with 15 patients matched for age, disease duration, and parkinsonian motor disability who underwent the same neurosurgical procedure under local anesthesia.
  
  
  METHODS
  Motor disability scores.
  
  
  RESULTS
  After surgery, the severity of parkinsonian motor disability was markedly improved in both groups of patients. Compared with patients who were under local anesthesia during the operation, the residual parkinsonian motor score under stimulation (with ["on"] or without ["off"] levodopa) and the intensity of stimulation were higher in patients who were under general anesthesia during the operation.
  
  
  CONCLUSIONS
  Although the improvement of parkinsonian motor disability is greater in PD patients who receive local anesthesia during surgery, general anesthesia can be performed in patients unable to tolerate prolonged states without levodopa.
authors.affiliation: Centre d'Investigation Clinique, Fédération de Neurologie, and INSERM U 289, Hôpital de la Salpêtrière, Paris, France.
authors.forename: David
authors.initials: D
authors.lastname: Maltête
authors.forename: Soledad
authors.initials: S
authors.lastname: Navarro
authors.forename: Marie-Laure
authors.initials: ML
authors.lastname: Welter
authors.forename: Sabine
authors.initials: S
authors.lastname: Roche
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Bonnet
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Houeto
authors.forename: Valérie
authors.initials: V
authors.lastname: Mesnage
authors.forename: Bernard
authors.initials: B
authors.lastname: Pidoux
authors.forename: Didier
authors.initials: D
authors.lastname: Dormont
authors.forename: Philippe
authors.initials: P
authors.lastname: Cornu
authors.forename: Yves
authors.initials: Y
authors.lastname: Agid
mesh_terms: D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D004185:Disability Evaluation; D004307:Dose-Response Relationship, Radiation; D004599:Electric Stimulation Therapy / Q000379:methods*; D004567:Electrodes, Implanted; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D010300:Parkinson Disease / Q000628:therapy*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D020531:Subthalamic Nucleus / Q000528:radiation effects*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000978:Antiparkinson Agents; D007980:Levodopa