Session Time: 12:30pm-2:00pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: To describe a patient underwent deep brain stimulation (DBS) with different target in left and right.
Background: DBS is a therapeutic option for movement disorders, including Parkinson’s disease (PD). Targets for DBS are commonly chosen symmetrically; e.g. bilateral subthalamic nucleus (STN) or bilateral globus pallidus interna (GPi). In this study we report DBS of the different target in right and left significantly improved severe unilateral dystonia in patient with familial PD.
Methods: A 49-year old man developed bradykinesia in the left upper and lower limb at the age of 39. Anti-Parkinson’s drugs were initially effective but he developed wearing-off and levodopa induced dyskinesia (LID) with dystonic component in the left upper limb at the age of 48. Because his dyskinesia and wearing off were difficult to control with medication, he decided to undergo DBS. As targets, right GPi was chosen to improve dystonia in his left upper extremity, and left STN was chosen because dystonia was absent in his left side and we expected to reduce medications. We evaluated the Unified Parkinson’s disease Rating Scale (UPDRS) Part III and Part IV score before and after the surgery.
Results: After the surgery, his symptoms was markedly improved (pre-operative: UPDRS Part III 21, Part IV 7, post-operative: UPDRS Part III 9, Part IV 4). Before the surgery he was taking ropinirol CR 16mg, levodopa/benzerazide 300mg, entacapone 300mg, zonisamide 50mg, after the surgery his medications reduced to ropinirol CR 14mg and levodopa/benzerazide 300mg.
Conclusions: Our case suggested that DBS with different target in left and right may be an effective therapeutic option for patients with different symptom in left and right.
The 9th Congress of The Movement Disorder Society of Japan, Oct 15-17, 2015. 5th Asian and Oceanian Parkinson’s disease and Movement Disorders Congress, March 11-13, 2016.
To cite this abstract in AMA style:S. Sekimoto, G. Oyama, T. Jo, A. Nakajima, Y. Shimo, M. Nakajima, A. Umemura, M. Ito, H. Arai, N. Hattori. “Two odd targets” strategy in deep brain stimulation for Parkinson’s disease with unilateral dystonia [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/two-odd-targets-strategy-in-deep-brain-stimulation-for-parkinsons-disease-with-unilateral-dystonia/. Accessed September 25, 2023.
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MDS Abstracts - https://www.mdsabstracts.org/abstract/two-odd-targets-strategy-in-deep-brain-stimulation-for-parkinsons-disease-with-unilateral-dystonia/