Deep-brain stimulation of the internal pallidum in multiple system atrophy

作者：Lambrecq V; Krim E^*; Meissner W; Guehl D; Tison F

来源：Revue Neurologique, 2008, 164(4): 398-402.

DOI：10.1016/j.neurol.2008.01.004

• multiple-system atrophy
• deep-brain stimulation
• internal pallidum
• atypical parkinsonism

Introduction. - The experience with deep-brain stimulation (DBS) in multiple-system atrophy (MSA) is sparse and generally disappointing. DBS is currently not recommended in MSA and its use is often related to a misdiagnosis.
Observation. - We describe the outcome of bilateral DBS of the internal pallidum in a 46-year-old woman suffering from MSA that initially resembled Parkinson's disease with prominent levodopa-induced dyskinesias. DBS of the left internal pallidum was performed in 1998 after a ten-year clinical course and improved dyskinesias. Six months later, the right side was implanted. A few months after the second surgery, the patient progressively developed signs of cerebellar and dysautonomic impairment and MSA was diagnosed.
Conclusion. - Our observation confirms the ineffectiveness of DBS of the internal pallidum in MSA and even suggests a harmful effect. DBS remains contra-indicated in atypical parkinsonism.

• 出版日期2008-4