1. Ineffective subthalamic nucleus stimulation in levodopa-resistant postischemic parkinsonism
- Author
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G Kunig, Abdelhamid Benazzouz, Nolasc Acarin, P. L. Dowsey, Alim-Louis Benabid, Klaus L. Leenders, Pierre Pollak, Paul Krack, and Jose A. Obeso
- Subjects
Male ,Antiparkinson Agents/therapeutic use ,Levodopa ,Deep brain stimulation ,medicine.medical_treatment ,Drug Resistance ,Myocardial Ischemia ,Substantia nigra ,Striatum ,Pharmacology ,Globus Pallidus ,DISEASE ,Antiparkinson Agents ,Subthalamic Nucleus ,medicine ,Humans ,Pallidotomy ,Parkinson Disease, Secondary/drug therapy/etiology/surgery ,Parkinson Disease, Secondary ,business.industry ,Parkinsonism ,Levodopa/therapeutic use ,Dopaminergic ,Middle Aged ,medicine.disease ,PALLIDOTOMY ,Electric Stimulation ,deep brain stimulation ,nervous system diseases ,Subthalamic Nucleus/*pathology/surgery ,Subthalamic nucleus ,nervous system ,postischemic parkinsonism ,Globus Pallidus/pathology ,Myocardial Ischemia/complications ,Neurology (clinical) ,business ,medicine.drug - Abstract
Article abstract The authors report a patient with postischemic parkinsonism who responded neither to levodopa nor to bilateral subthalamic nucleus (STN) stimulation. MRI revealed bilateral lesions of the substantia nigra, the striatum, the external pallidum, and part of the internal pallidum. PET showed reduced striatal dopa-decarboxylase activity, D2 receptor binding, and glucose metabolism. Perioperative microrecording showed low-frequency activity of STN cells. This case suggests that parkinsonian patients who do not have a good response to levodopa or in whom a postsynaptic dopaminergic lesion can be shown may not be good candidates for STN surgery.
- Published
- 2000
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