Ineffective subthalamic nucleus stimulation in levodopa-resistant postischemic parkinsonism
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.
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© 2000.
Publication History
Received: August 6, 1999
Accepted: February 10, 2000
Published online: June 13, 2000
Published in print: June 13, 2000
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