Further experience with extradural motor cortex stimulation for treatment of advanced Parkinson's disease. Report of 3 new cases

J Neurosurg Sci. 2003 Dec;47(4):189-93.

Abstract

Aim: To report the results obtained with the extradural motor cortex stimulation in Parkinson's disease.

Methods: Three patients were submitted to MRI images and functional MRI in order to identify the upper limb motor area. Then a quadripolar electrostimulator was introduced in the extradural space, through 2 burr holes.

Results: Unilateral, extradural motor cortex stimulation relieves, at least partially, but sometime dramatically, the whole spectrum of symptoms in advanced Parkinson disease: tremor and rigor bilaterally in all limbs; akinesia; standing, anteropulsion, gait; motor performance; dysphagia; speech and swallowing. Also the symptoms of long term dopa syndrome--dyskinesias, and other secondary effect of L-dopa administration, psychiatric symptoms--are improved.

Conclusion: The results seems do not fade away with time. Drug dosage may be reduced by 50%. We suggest early employ of transdural motor cortex stimulation.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Deglutition Disorders / etiology
  • Deglutition Disorders / therapy
  • Dura Mater / anatomy & histology
  • Dyskinesia, Drug-Induced / therapy
  • Electric Stimulation Therapy / instrumentation
  • Electric Stimulation Therapy / methods*
  • Electrodes / standards
  • Electrodes, Implanted
  • Female
  • Gait Disorders, Neurologic / etiology
  • Gait Disorders, Neurologic / therapy
  • Humans
  • Levodopa / administration & dosage
  • Levodopa / adverse effects
  • Magnetic Resonance Imaging
  • Male
  • Motor Cortex / anatomy & histology
  • Motor Cortex / physiopathology*
  • Muscle Rigidity / etiology
  • Muscle Rigidity / therapy
  • Parkinson Disease / physiopathology*
  • Parkinson Disease / therapy*
  • Treatment Outcome
  • Tremor / etiology
  • Tremor / therapy

Substances

  • Levodopa