title: Deep brain stimulation of the internal segment of the globus pallidus in delayed runaway dyskinesia.
abstract: BACKGROUND
  Dyskinesias that occur during a period without medication after embryonic cell transplantation have been commonly reported in double-blind trials; however, to date, they have not been reported in the few patients who participated in open-label pilot studies.
  
  
  METHODS
  Single case observation with preoperative and postoperative data, and intraoperative single-cell physiology.
  
  
  METHODS
  A patient who underwent embryonic cell transplantation in 1993 as part of the University of South Florida open-label study was referred for evaluation of intractable dyskinesia of the right arm. The dyskinesia was present during evaluation of the patient after a 12-hour period without medication and was clinically disabling. It was manifested as a severe groping movement of the hand. Intraoperative physiologic evaluation revealed decreased firing rates in the internal segment of the globus pallidus.
  
  
  RESULTS
  Deep brain stimulation of the internal segment of the globus pallidus resulted in resolution of the dyskinesia.
  
  
  CONCLUSIONS
  This case highlights the delayed development of runaway dyskinesia after a period without medication as an important potential long-term adverse effect of embryonic cell transplantation in patients with Parkinson disease.
authors.affiliation: Department of Neurology, University of Florida Movement Disorders Center, University of Florida, Gainesville, FL, USA.
authors.forename: John
authors.initials: J
authors.lastname: Graff-Radford
authors.forename: Kelly D
authors.initials: KD
authors.lastname: Foote
authors.forename: Ramon L
authors.initials: RL
authors.lastname: Rodriguez
authors.forename: Hubert H
authors.initials: HH
authors.lastname: Fernandez
authors.forename: Robert A
authors.initials: RA
authors.lastname: Hauser
authors.forename: Atchar
authors.initials: A
authors.lastname: Sudhyadhom
authors.forename: Christian A
authors.initials: CA
authors.lastname: Rosado
authors.forename: Justin C
authors.initials: JC
authors.lastname: Sanchez
authors.forename: Michael S
authors.initials: MS
authors.lastname: Okun
mesh_terms: D046690:Deep Brain Stimulation / Q000379:methods*; D020820:Dyskinesias / Q000503:physiopathology / Q000628:therapy*; D005917:Globus Pallidus / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000503:physiopathology / Q000628:therapy; D033581:Stem Cell Transplantation / Q000009:adverse effects