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Inhibition of levodopa effects by internal pallidal stimulation

Limousin, P
Hoffmann, D
Benazzouz, A
Benabid, A L
Published in Movement Disorders. 1998, vol. 13, no. 4, p. 648-52
Abstract We report three patients with bilateral GPi stimulation for stage 4 Parkinson's disease (PD) with severe levodopa-induced dyskinesias (LID). In all three it was possible to completely inhibit LID using high-stimulation parameters. Parallel to complete inhibition of LID, an inhibition of the anti-akinetic effect of levodopa was observed, whereas, at the same time, rigidity was markedly improved. GPi stimulation is adaptable over time, and stimulation parameters have to be programmed according to off- and on-period motor symptoms. The main interest of stimulation is the possibility of finding a compromise between LID alleviation in on-phase without loss of the beneficial motor effects and improvement in parkinsonism in off-phase. In some patients, residual dyskinesias have to be accepted so as not to aggravate on-period motor symptoms by a presumed overinhibition of basal ganglia outflow.
Keywords Antiparkinson Agents/administration & dosage/adverse effectsCombined Modality TherapyDominance, Cerebral/drug effects/physiologyDyskinesia, Drug-Induced/diagnosis/physiopathology/therapyElectric Stimulation TherapyElectrodes, ImplantedGlobus Pallidus/drug effects/physiopathologyHumansLevodopa/administration & dosage/adverse effectsMaleMiddle AgedParkinson Disease/physiopathology/therapy
PMID: 9686769
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KRACK, Paul et al. Inhibition of levodopa effects by internal pallidal stimulation. In: Movement Disorders, 1998, vol. 13, n° 4, p. 648-52. doi: 10.1002/mds.870130407

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