End of day dyskinesia in advanced Parkinson's disease can be eliminated by bilateral subthalamic nucleus or globus pallidus deep brain stimulation

We report the therapeutic effects of deep brain stimulation (DBS) in 2 patients with Parkinson's disease (PD) with severe end of dose dyskinesia that was resistant to medical therapy. In both patients, severe, end of day ballistic dyskinesias occurred when the last levodopa dose of the day was wearing off. Globus pallidus (GPi) DBS in 1 case and subthalamic (STN) DBS in the second case produced full resolution of end of day dyskinesia. © 2006 Movement Disorder Society

[1]  A. Benabid,et al.  Opposite motor effects of pallidal stimulation in Parkinson's disease , 1998, Annals of neurology.

[2]  M. Muenter,et al.  Patterns of dystonia ("I-D-I" and "D-I-D-") in response to l-dopa therapy for Parkinson's disease. , 1977, Mayo Clinic proceedings.

[3]  A. Lang,et al.  Severe evening dyskinesias in advanced Parkinson's disease: Clinical description, relation to plasma levodopa, and treatment , 2004, Movement disorders : official journal of the Movement Disorder Society.

[4]  S Fahn,et al.  The spectrum of levodopa-induced dyskinesias. , 2000, Annals of neurology.

[5]  Niels Sunde,et al.  Effects of bilateral stimulation of the subthalamic nucleus in patients with severe Parkinson's disease and motor fluctuations , 2002, Movement disorders : official journal of the Movement Disorder Society.

[6]  K. Shannon,et al.  Tongue Protrusion Dystonia: Treatment With Botulinum Toxin , 1997, Southern medical journal.

[7]  J. D. Parkes,et al.  Fluctuations of disability in Parkinson's disease – clinical aspects , 1981 .

[8]  J. Jankovic,et al.  Tetrabenazine treatment for tardive dyskinesia: assessment by randomized videotape protocol. , 1999, The American journal of psychiatry.

[9]  A L Benabid,et al.  From off-period dystonia to peak-dose chorea. The clinical spectrum of varying subthalamic nucleus activity. , 1999, Brain : a journal of neurology.

[10]  S. McAninch,et al.  Focal lingual dystonia, urinary incontinence, and sensory deficits secondary to low voltage electrocution: case report and literature review , 2002, Emergency medicine journal : EMJ.

[11]  J. Rabey,et al.  Botulinum toxin for the treatment of oro‐facial‐lingual‐masticatory tardive dyskinesia , 2000, Movement disorders : official journal of the Movement Disorder Society.

[12]  M. Bareš,et al.  Treatment of facial and orolinguomandibular tardive dystonia by botulinum toxin a: Evidence of a long‐lasting effect , 1999, Movement disorders : official journal of the Movement Disorder Society.

[13]  J. Mcgrath,et al.  The treatment of tardive dyskinesia—a systematic review and meta-analysis , 1999, Schizophrenia Research.

[14]  ONSET AND END-OF-DOSE LEVODOPA-INDUCED DYSKINESIAS , 1978 .

[15]  P. V. van Harten,et al.  [Tardive dystonia]. , 1992, Nederlands tijdschrift voor geneeskunde.

[16]  J. Obeso,et al.  Levodopa‐induced dyskinesias in Parkinson's disease: Clinical and pharmacological classification , 1992, Movement disorders : official journal of the Movement Disorder Society.

[17]  M. Brin,et al.  Botulinum toxin injections for lingual dystonia , 1991, The Laryngoscope.

[18]  Y. Agid,et al.  Onset and end-of-dose levodopa-induced dyskinesias. Possible treatment by increasing the daily doses of levodopa. , 1978, Archives of neurology.

[19]  J. Villemure,et al.  l-Dopa-induced dyskinesia improvement after STN-DBS depends upon medication reduction , 2004, Neurology.

[20]  P. Krack,et al.  Deep-brain stimulation of the subthalamic nucleus or the pars interna of the globus pallidus in Parkinson's disease. , 2001, The New England journal of medicine.

[21]  R. Alterman,et al.  Immediate and sustained relief of levodopa-induced dyskinesias after dorsal relocation of a deep brain stimulation lead. Case report. , 2004, Neurosurgical focus.