title: Combined pallidal and subthalamic nucleus stimulation in sporadic dystonia-parkinsonism.
abstract: Multifocal deep brain stimulation (DBS) is a new technique that has been introduced recently. A 39-year-old man with dystonia-parkinsonism underwent the simultaneous implantation of subthalamic nucleus (STN) and globus pallidus internus (GPi) DBS electrodes.   While bilateral STN DBS controlled the parkinsonian symptoms well and allowed for a reduction in levodopa, the improvement of dystonia was only temporary. Additional GPi DBS also alleviated dystonic symptoms. Formal assessment at the 1-year follow-up showed that both the parkinsonian symptoms and the dystonia were markedly improved via continuous bilateral combined STN and GPi stimulation. Sustained benefit was achieved at 3 years postoperatively.
authors.affiliation: Department of Neurology, University Hospital Mannheim, Germany.
authors.forename: Johannes C
authors.initials: JC
authors.lastname: Wöhrle
authors.forename: Christian
authors.initials: C
authors.lastname: Blahak
authors.forename: Hans-Holger
authors.initials: HH
authors.lastname: Capelle
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Fogel
authors.forename: Hansjoerg
authors.initials: H
authors.lastname: Bäzner
authors.forename: Joachim K
authors.initials: JK
authors.lastname: Krauss
mesh_terms: D046690:Deep Brain Stimulation / Q000379:methods*; D004421:Dystonia / Q000503:physiopathology / Q000628:therapy*; D020821:Dystonic Disorders / Q000503:physiopathology / Q000628:therapy*; D005917:Globus Pallidus / Q000503:physiopathology*; D006801:Humans; D008297:Male; D020734:Parkinsonian Disorders / Q000503:physiopathology / Q000628:therapy*; D020531:Subthalamic Nucleus / Q000503:physiopathology*; D016896:Treatment Outcome