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Journal of Neural Transmission

, Volume 117, Issue 3, pp 349–351 | Cite as

Secondary failure after ten years of pallidal neurostimulation in a patient with advanced Parkinson’s disease

  • Niels AllertEmail author
  • Ralph Lehrke
  • Volker Sturm
  • Jens Volkmann
Movement Disorders - Short Communication

Abstract

Deep-brain stimulation of the subthalamic nucleus and internal globus pallidus are both surgical options in advanced Parkinson’s disease. The best target is still debated with data suggesting better motor outcome in subthalamic stimulation but higher rates of psychiatric problems. Failure of pallidal stimulation within the first 2 years has been described. Here, we report a patient with good response to pallidal neurostimulation who developed a secondary failure after 10 years of treatment which was successfully reversed by reimplanting the electrodes into the subthalamic nucleus. This case suggests that a controlled comparison of treatment efficacy of pallidal and subthalamic neurostimulation may require a very long follow-up period to yield reliable results.

Keywords

Deep-brain stimulation Subthalamic nucleus Globus pallidus internus 

Supplementary material

The video depicts the medication ON/stimulation OFF state (0:00-0:15 min) and the medication ON/stimulation ON state (0:16-0:55 min) after 3 years of GPi stimulation, followed by the medication OFF/stimulation ON state (0:56-1:17 min) and medication ON/stimulation ON state (1:18-1:49 min) after 10 years of GPi stimulation and finally the medication OFF/stimulation ON state after 1 year of STN stimulation (1:50-2:25 min). (MPG 15,286 KB)

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Niels Allert
    • 1
    Email author
  • Ralph Lehrke
    • 2
  • Volker Sturm
    • 3
  • Jens Volkmann
    • 4
  1. 1.Neurological Rehabilitation Center GodeshoeheBonnGermany
  2. 2.St. Barbara-Klinik Hamm-HeessenHammGermany
  3. 3.Department of Stereotaxy and Functional NeurosurgeryUniversity of CologneKoelnGermany
  4. 4.Department of NeurologyChristian-Albrechts-UniversityKielGermany

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