Abstract
OBJECTIVE: Subthalamic (Stn) deep brain stimulation (DBS) is a valid surgical therapy for the treatment of severe Parkinson's disease. In recent years, StnDBS has been proposed for patients who previously received other surgical treatments, such as thalamotomy and pallidotomy. Nonetheless, there is no consensus about the indications of DBS in patients who previously underwent surgery. To the best of our knowledge this is the first reported case of a patient treated with DBS after previous thalamotomy and adrenal grafting. CLINICAL PRESENTATION: A 62-year-old man with a long history (more than 30 yr) of Parkinson's disease received unilateral thalamotomy and autologous adrenal graft on two independent occasions. Thalamotomy led to a significant improvement, although limited to the control of contralateral tremor. The autologous adrenal graft was of no benefit. For the subsequent occurrence of L-dopa related dyskinesias and severe "off" periods, the patient was referred to our center for StnDBS. INTERVENTION: The patient underwent bilateral StnDBS, obtaining a satisfactory improvement of rigidity and bradykinesia on both sides. The 1-year follow-up evaluation showed a 46% improvement in the Unified Parkinson's Disease Rating Scale motor section, along with a noticeable reduction in antiparkinsonian therapy (81%). CONCLUSION: This case is consistent with previous reports from the literature, suggesting that StnDBS is feasible and safe, even in patients who previously received other surgical treatments for Parkinson's disease, such as thalamotomy or cell grafting.
| Original language | English |
|---|---|
| Pages (from-to) | 1146-1149 |
| Number of pages | 4 |
| Journal | Neurosurgery |
| Volume | 59 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - Nov 2006 |
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Keywords
- Adrenal grafting
- Parkinson's disease
- Subthalamic deep brain stimulation
- Thalamotomy
ASJC Scopus subject areas
- Clinical Neurology
- Surgery
Cite this
Bilateral subthalamic deep brain stimulation in a patient with Parkinson's disease who had previously undergone thalamotomy and autologous adrenal grafting in the caudate nucleus : Case report. / Vergani, Francesco; Landi, Andrea; Antonini, Angelo; Sganzerla, Erik P.
In: Neurosurgery, Vol. 59, No. 5, 11.2006, p. 1146-1149.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Bilateral subthalamic deep brain stimulation in a patient with Parkinson's disease who had previously undergone thalamotomy and autologous adrenal grafting in the caudate nucleus
T2 - Case report
AU - Vergani, Francesco
AU - Landi, Andrea
AU - Antonini, Angelo
AU - Sganzerla, Erik P.
PY - 2006/11
Y1 - 2006/11
N2 - OBJECTIVE: Subthalamic (Stn) deep brain stimulation (DBS) is a valid surgical therapy for the treatment of severe Parkinson's disease. In recent years, StnDBS has been proposed for patients who previously received other surgical treatments, such as thalamotomy and pallidotomy. Nonetheless, there is no consensus about the indications of DBS in patients who previously underwent surgery. To the best of our knowledge this is the first reported case of a patient treated with DBS after previous thalamotomy and adrenal grafting. CLINICAL PRESENTATION: A 62-year-old man with a long history (more than 30 yr) of Parkinson's disease received unilateral thalamotomy and autologous adrenal graft on two independent occasions. Thalamotomy led to a significant improvement, although limited to the control of contralateral tremor. The autologous adrenal graft was of no benefit. For the subsequent occurrence of L-dopa related dyskinesias and severe "off" periods, the patient was referred to our center for StnDBS. INTERVENTION: The patient underwent bilateral StnDBS, obtaining a satisfactory improvement of rigidity and bradykinesia on both sides. The 1-year follow-up evaluation showed a 46% improvement in the Unified Parkinson's Disease Rating Scale motor section, along with a noticeable reduction in antiparkinsonian therapy (81%). CONCLUSION: This case is consistent with previous reports from the literature, suggesting that StnDBS is feasible and safe, even in patients who previously received other surgical treatments for Parkinson's disease, such as thalamotomy or cell grafting.
AB - OBJECTIVE: Subthalamic (Stn) deep brain stimulation (DBS) is a valid surgical therapy for the treatment of severe Parkinson's disease. In recent years, StnDBS has been proposed for patients who previously received other surgical treatments, such as thalamotomy and pallidotomy. Nonetheless, there is no consensus about the indications of DBS in patients who previously underwent surgery. To the best of our knowledge this is the first reported case of a patient treated with DBS after previous thalamotomy and adrenal grafting. CLINICAL PRESENTATION: A 62-year-old man with a long history (more than 30 yr) of Parkinson's disease received unilateral thalamotomy and autologous adrenal graft on two independent occasions. Thalamotomy led to a significant improvement, although limited to the control of contralateral tremor. The autologous adrenal graft was of no benefit. For the subsequent occurrence of L-dopa related dyskinesias and severe "off" periods, the patient was referred to our center for StnDBS. INTERVENTION: The patient underwent bilateral StnDBS, obtaining a satisfactory improvement of rigidity and bradykinesia on both sides. The 1-year follow-up evaluation showed a 46% improvement in the Unified Parkinson's Disease Rating Scale motor section, along with a noticeable reduction in antiparkinsonian therapy (81%). CONCLUSION: This case is consistent with previous reports from the literature, suggesting that StnDBS is feasible and safe, even in patients who previously received other surgical treatments for Parkinson's disease, such as thalamotomy or cell grafting.
KW - Adrenal grafting
KW - Parkinson's disease
KW - Subthalamic deep brain stimulation
KW - Thalamotomy
UR - http://www.scopus.com/inward/record.url?scp=33845223664&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33845223664&partnerID=8YFLogxK
U2 - 10.1227/01.NEU.0000245585.93284.15
DO - 10.1227/01.NEU.0000245585.93284.15
M3 - Article
VL - 59
SP - 1146
EP - 1149
JO - Neurosurgery
JF - Neurosurgery
SN - 0148-396X
IS - 5
ER -