Turkish Neurosurgery 2013 , Vol 23 , Num 1
Bilateral Globus Pallidus Internus Deep Brain Stimulation in Parkinson's Disease with Periodic Limb Movement Disorder
Bryan T. KLASSEN1, Mark K. LYONS2, Virgilio Gerald H. EVIDENTE1
1Mayo Clinic Arizona, Departments of Neurology , Phoenix/AZ, USA
2Mayo Clinic Arizona, Departments of Neurological Surgery, Phoenix/AZ, USA
DOI : 10.5137/1019-5149.JTN.4198-11.1 Deep brain stimulation for Parkinson's disease is a well-established therapeutic intervention for refractory disease. The main nuclear targets are the subthalamic nucleus and the globus pallidus internus. Periodic limb movements are often an associated condition in patients with Parkinson's disease. Both conditions can respond to dopaminergic agents. The case of a 57-year-old man with severe Parkinson's disease and periodic limb movement who underwent bilateral globus pallidus deep brain stimulation surgery for his Parkinson's disease is presented and discussed. Intraoperatively the patient's periodic limb movements responded to voltage stimulation higher than those required for improvement of his parkinsonian symptoms. The immediate and reversible improvement in these symptoms contralateral to the stimulation site suggests pallidal stimulation may directly ameliorate periodic limb movement symptoms. Keywords : Deep brain stimulation, Globus pallidus, Parkinson's disease, Periodic limb movements
Corresponding author : Mark Lyons, lyons.mark2@mayo.edu