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. 2017 Jul-Sep;20(3):199-206.
doi: 10.4103/aian.AIAN_244_17.

Surgical Treatment of Levodopa-induced Dyskinesia in Parkinson's Disease

Syam Krishnan  1 , Krishnakumar Kesava Pisharady  1
Affiliations

Surgical Treatment of Levodopa-induced Dyskinesia in Parkinson's Disease

Syam Krishnan et al. Ann Indian Acad Neurol. 2017 Jul-Sep.

Abstract

The treatment of motor manifestations of Parkinson's disease (PD) is essentially a trade-off between adequate relief of motor symptoms and prevention and control of motor complications, particularly levodopa-induced dyskinesia (LID). Progression of PD is paralleled by a progressive difficulty in achieving the balance. Functional neurosurgical procedures provide sustained relief of LID in carefully selected patients when further tailoring of medical therapy fails to achieve this goal. Though deep brain stimulation (DBS) has superseded lesioning surgeries, pallidotomy still has a role in those patients in whom DBS is not feasible for financial or other reasons.

Keywords: Deep brain stimulation; Parkinson's disease; levodopa-induced dyskinesia; pallidotomy.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
X-ray showing deep brain stimulation hardware implanted in a patient. Figure 1A shows the extra-cranial components and 1B, the intracranial components. (1) pulse generator, (2) extension wire (3) deep brain stimulation lead (4) tip of the lead with four electrode contacts implanted in the target
Figure 2
Figure 2
Postoperative magnetic resonance imaging scan showing deep brain stimulation lead implanted in the subthalamic nuclei. (a) Axial section (b) coronal section. Arrows point to the implanted lead tips
Figure 3
Figure 3
Postoperative magnetic resonance imaging scan showing deep brain stimulation leads implanted in the internal globus pallidus. (a) Axial section (b) coronal section. Arrows point to the implanted lead tips
Figure 4
Figure 4
Postoperative computed tomography scan of a patient with Parkinson's disease who underwent left pallidotomy. (a) Axial image (b) coronal reconstruction. Arrow points to the surgically created lesion
See this image and copyright information in PMC

References

    1. Morrish PK, Sawle GV, Brooks DJ. An [18F] dopa-PET and clinical study of the rate of progression in Parkinson's disease. Brain. 1996;119(Pt 2):585–91. - PubMed
    1. Ishikawa T, Dhawan V, Kazumata K, Chaly T, Mandel F, Neumeyer J, et al. Comparative nigrostriatal dopaminergic imaging with iodine-123-beta CIT-FP/SPECT and fluorine-18-FDOPA/PET. J Nucl Med. 1996;37:1760–5. - PubMed
    1. Agid Y, Ahlskog E, Albanese A, Calne D, Chase T, De Yebenes J, et al. Levodopa in the treatment of Parkinson's disease: A consensus meeting. Mov Disord. 1999;14:911–3. - PubMed
    1. Salat D, Tolosa E. Levodopa in the treatment of Parkinson's disease: Current status and new developments. J Parkinsons Dis. 2013;3:255–69. - PubMed
    1. Rascol O, Payoux P, Ory F, Ferreira JJ, Brefel-Courbon C, Montastruc JL. Limitations of current Parkinson's disease therapy. Ann Neurol. 2003;53(Suppl 3):S3–12. - PubMed