Subject(s)
Deep Brain Stimulation/methods , Dystonia/physiopathology , Dystonia/therapy , Globus Pallidus/anatomy & histology , Pantothenate Kinase-Associated Neurodegeneration/complications , Age Factors , Artifacts , Child , Deep Brain Stimulation/standards , Dystonia/enzymology , Female , Globus Pallidus/growth & development , Globus Pallidus/physiopathology , Humans , Intraoperative Complications/prevention & control , Male , Neural Pathways/anatomy & histology , Neural Pathways/physiopathology , Neuronavigation/methods , Neuronavigation/standards , Recovery of Function/physiology , Reproducibility of ResultsSubject(s)
Carotid Artery Diseases/chemically induced , Fluoxetine/adverse effects , Neck Pain/chemically induced , Selective Serotonin Reuptake Inhibitors/adverse effects , Adult , Fluoxetine/therapeutic use , Humans , Male , Migraine Disorders/drug therapy , Selective Serotonin Reuptake Inhibitors/therapeutic useABSTRACT
The role of endogenous dopamine in severe Parkinson's disease is often underestimated. We report on a case of acute general motor worsening induced by the ingestion of fluphenazine in a parkinsonian patient successfully treated with STN DBS. Other etiologies were ruled out. Clinical improvement was gradual and fully reversible 4 days after discontinuation of the antidopaminergic drug. We suggest that residual striatal and extrastriatal dopaminergic pathways still play a paramount role in mediating central neurotrasmissions that may take part in STN DBS's mechanism of action.
Subject(s)
Deep Brain Stimulation , Dopamine/physiology , Parkinson Disease/surgery , Subthalamic Nucleus/surgery , Adult , Deep Brain Stimulation/methods , Dopamine Antagonists/adverse effects , Dopamine Antagonists/therapeutic use , Humans , Male , Parkinson Disease/drug therapy , Parkinson Disease/pathology , Subthalamic Nucleus/pathologySubject(s)
Abdominal Muscles/drug effects , Antiemetics/adverse effects , Benzamides/adverse effects , Dopamine Antagonists/adverse effects , Dyskinesia, Drug-Induced/etiology , Antiemetics/therapeutic use , Benzamides/therapeutic use , Diagnosis, Differential , Dopamine Antagonists/therapeutic use , Dyskinesia, Drug-Induced/diagnosis , Dyskinesia, Drug-Induced/therapy , Humans , Nocturnal Myoclonus Syndrome/chemically induced , Nocturnal Myoclonus Syndrome/diagnosis , Nocturnal Myoclonus Syndrome/therapy , Transcutaneous Electric Nerve StimulationSubject(s)
Dietary Carbohydrates/therapeutic use , Dietary Fats/therapeutic use , Dietary Proteins , Ketones/blood , Parkinson Disease/diet therapy , Body Mass Index , Feasibility Studies , Humans , Parkinson Disease/physiopathology , Patient Compliance , Reproducibility of Results , Treatment Outcome , Weight LossABSTRACT
Objective. The objective of this study was to report our observations on the external electromagnetic field influences on deep brain stimulation (DBS) in our patient population and how these influences affected our patients' lives and other healthcare-related conditions. Materials and Methods. We have retrospectively analyzed data concerning the effects of external electromagnetic fields on 172 of our patients implanted with DBS. Results. Identifiable electromagnetic sources turned the implantable pulse generator (IPG) off in 20 patients. In two patients, these episodes necessitated replacement of the Itrel II IPG (Medtronic Inc., Minneapolis, MN, USA) with the magnetically shielded Kinetra IPG (Medtronic Inc.). Six patients received cardiac pacemakers, leading, in two patients, to interference between the systems. Our experience concerning magnetic resonance imaging, electrocardiogram (ECG), heart defibrillation, electro-cautery, and other sources of electromagnetic interference also is described. Conclusions. External electromagnetic interference may, in rare cases, constitute a severe threat to the well-being of the patient implanted with a DBS system. Also, malfunction of a DBS system may constitute a medical emergency. Nevertheless, in spite of these external electromagnetic influences, we consider DBS to be a safe method, provided safety protocols are followed, and provided that provider awareness about potential hazards is present.
