title: Unilateral subthalamic nucleus deep brain stimulation contralateral to thalamic stimulation in Parkinson disease.
abstract: The effects of unilateral subthalamic nucleus (STN) stimulation contralateral to thalamic stimulation in Parkinson disease (PD) have not been previously reported. We are reporting a patient who developed left arm tremor in 1994, at age 62, as her first PD symptom. She underwent right thalamic DBS surgery in 1999 that resulted in complete resolution of left arm tremor. Her PD symptoms progressed and she developed severe motor fluctuations and disabling dyskinesias. In 2003, she underwent left STN electrode implantation. Left STN stimulation improved contralateral motor scores in the medication OFF state, and allowed for reduced medication doses and less dyskinesia. However, there was no significant improvement in activities of daily living (ADL), motor scores in the medication ON state, gait, or postural stability.
authors.affiliation: VAPSHCS, Department of Neurology, University of Washington School of Medicine, Mailstop 127, 1660 S. Columbian Way, Seattle, WA 98108, USA. asamii@u.washington.edu
authors.forename: Ali
authors.initials: A
authors.lastname: Samii
authors.forename: Jefferson C
authors.initials: JC
authors.lastname: Slimp
authors.forename: Robert
authors.initials: R
authors.lastname: Goodkin
mesh_terms: D046690:Deep Brain Stimulation / Q000379:methods*; D020820:Dyskinesias / Q000628:therapy; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008875:Middle Aged; D010300:Parkinson Disease / Q000628:therapy*; D020531:Subthalamic Nucleus / Q000502:physiology*; D013788:Thalamus / Q000502:physiology*