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Résistances thérapeutiques dans les mouvements anormaux

Published in Revue médicale suisse. 2012, vol. 8, no. 339, p. 926-9
Abstract Therapeutic strategies for essential tremor (ET) and Parkinson's disease (PD) can be divided into two successive steps, one based on oral medications and the other, more invasive, using pumps or functional neurosurgery. When ET becomes refractory to propranolol, primidone and other, second-choice compounds, deep brain stimulation of the VIM nucleus of the thalamus can be considered. When PD becomes resistant to dopamine replacement therapy using various combinations of dopaminergic agents, then three options can be discussed: first, a subcutaneous apomorphine mini-pump, second, a jejunal levodopa-delivery system by means of percutaneous gastrostomy, and third, bilateral deep brain stimulation of the subthalamic nucleus. The above interventions are successful in about 80% of cases.
Keywords Antiparkinson Agents/administration & dosage/therapeutic useApomorphine/administration & dosage/therapeutic useDeep Brain Stimulation/methods/psychology/utilizationDrug Resistance/physiologyEssential Tremor/diagnosis/etiology/therapyHumansLevodopa/administration & dosage/therapeutic useMovement Disorders/diagnosis/etiology/therapyNeurosurgery/methodsParkinson Disease/diagnosis/etiology/therapyTreatment Failure
PMID: 22675821
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Other version: http://rms.medhyg.ch/numero-339-page-926.htm
Research group Groupe Pierre Burkhard (neurologie) (154)
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VINGERHOETS, François, BURKHARD, Pierre. Résistances thérapeutiques dans les mouvements anormaux. In: Revue médicale suisse, 2012, vol. 8, n° 339, p. 926-9. https://archive-ouverte.unige.ch/unige:32853

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Deposited on : 2014-01-07

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