OFF-off rebound dyskinesia in subthalamic nucleus deep brain stimulation of Parkinson's disease.
A 61-year-old man with Parkinson's disease (PD), motor fluctuations, and dyskinesias underwent bilateral implantation of deep brain stimulation (DBS) electrodes in the subthalamic nucleus (STN). One month after surgery, DBS was optimized to bilateral monopolar settings at the most proximal electrode just superior to the STN, which improved motor fluctuations and dyskinesias. At several postoperative evaluations off medications overnight, both stimulators were turned off and within 60 seconds he developed severe dyskinesias. When the stimulators were turned back on, the dyskinesias soon resolved. This article is a first report of a unique pattern of rebound-type dyskinesia that occurred in the off medication state produced by stopping STN DBS.
Brodsky
Matthew A
MA
Department of Neurology, Oregon Health & Science University, and Parkinson's Disease Research, Education & Clinical Care Center, Portland VA Medical Center, Portland, Oregon, USA.
Hogarth
Penelope
P
Nutt
John G
JG
D000978:Antiparkinson Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002230:Carbidopa / Q000008:administration & dosage* / Q000009:adverse effects; D003131:Combined Modality Therapy; D003342:Corpus Striatum / Q000503:physiopathology; D046690:Deep Brain Stimulation; D004292:Dominance, Cerebral / Q000502:physiology; D004359:Drug Therapy, Combination; D020820:Dyskinesias / Q000503:physiopathology / Q000534:rehabilitation*; D004567:Electrodes, Implanted; D006801:Humans; D007980:Levodopa / Q000008:administration & dosage* / Q000009:adverse effects; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination / Q000187:drug effects; D010300:Parkinson Disease / Q000503:physiopathology / Q000534:rehabilitation*; D055502:Secondary Prevention; D013238:Stereotaxic Techniques; D013375:Substance Withdrawal Syndrome / Q000209:etiology / Q000503:physiopathology; D020531:Subthalamic Nucleus / Q000503:physiopathology*
D000978:Antiparkinson Agents; D007980:Levodopa; D002230:Carbidopa