title: Eight-years failure of subthalamic stimulation rescued by globus pallidus implant.
abstract: BACKGROUND
  Deep brain stimulation is the surgical procedure of choice in patients with Parkinson's disease. The subthalamic nucleus and the globus pallidus interna are the two most common targets used to treat Parkinson's disease.
  
  
  METHODS
  We describe three patients with previous effective subthalamic deep brain stimulation in whom globus pallidus interna deep brain stimulation was performed as "rescue" surgery, 8 years after the original operation.
  
  
  RESULTS
  Two years after globus pallidus surgery the reduction of dystonia and dyskinesias led to an improvement of motor symptoms. In two patients, painful dystonias disappeared and motor fluctuations markedly improved. One patient achieved an improvement in freezing.
  
  
  CONCLUSIONS
  After 24 months of follow up, our observations suggest that globus pallidus deep brain stimulation, can improve motor fluctuations, dyskinesia and axial symptoms.
authors.affiliation: Parkinson's Disease and Movement Disorders Unit, National Institute of Neurology Foundation "C. Mondino", Pavia, Italy; Interdepartmental Research Center for Neurodegenerative Disease, National Institute of Neurology Foundation "C. Mondino", Pavia, Italy. Electronic address: bri_mi@hotmail.it.
authors.forename: Brigida
authors.initials: B
authors.lastname: Minafra
authors.affiliation: Movement Disorders Center, TWH, UHN, Division of Neurology, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Fasano
authors.affiliation: Parkinson's Disease and Movement Disorders Unit, National Institute of Neurology Foundation "C. Mondino", Pavia, Italy; Interdepartmental Research Center for Neurodegenerative Disease, National Institute of Neurology Foundation "C. Mondino", Pavia, Italy.
authors.forename: Nicolò Gabriele
authors.initials: NG
authors.lastname: Pozzi
authors.affiliation: Parkinson's Disease and Movement Disorders Unit, National Institute of Neurology Foundation "C. Mondino", Pavia, Italy; Interdepartmental Research Center for Neurodegenerative Disease, National Institute of Neurology Foundation "C. Mondino", Pavia, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Zangaglia
authors.affiliation: Functional Neurosurgical Unit, IRCCS "Galeazzi", Milano, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Servello
authors.affiliation: Parkinson's Disease and Movement Disorders Unit, National Institute of Neurology Foundation "C. Mondino", Pavia, Italy; Interdepartmental Research Center for Neurodegenerative Disease, National Institute of Neurology Foundation "C. Mondino", Pavia, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Pacchetti
mesh_terms: D000328:Adult; D046690:Deep Brain Stimulation / Q000379:methods*; D005260:Female; D005917:Globus Pallidus / Q000503:physiopathology*; D006801:Humans; D008297:Male; D010300:Parkinson Disease / Q000503:physiopathology / Q000628:therapy*; D019233:Retreatment; D020531:Subthalamic Nucleus / Q000503:physiopathology*; D017211:Treatment Failure; D016896:Treatment Outcome
keywords: Deep brain stimulation; Globus pallidus interna; Parkinson's disease; Subthalamic nucleus