Ineffective subthalamic nucleus stimulation in levodopa-resistant postischemic parkinsonism
Krack P, Dowsey PL, Benabid AL, Acarin N, Benazzouz A, Künig G, Leenders KL, Obeso JA, Pollak P.
Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France
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.
CITA DEL ARTÍCULO Neurology. 2000 Jun 13;54(11):2182-4