[Deep-brain stimulation of the internal pallidum in multiple system atrophy]

Rev Neurol (Paris). 2008 Apr;164(4):398-402. doi: 10.1016/j.neurol.2008.01.004. Epub 2008 Mar 25.
[Article in French]


Introduction: The experience with deep-brain stimulation (DBS) in multiple-system atrophy (MSA) is sparse and generally disappointing. DBS is currently not recommended in MSA and its use is often related to a misdiagnosis.

Observation: We describe the outcome of bilateral DBS of the internal pallidum in a 46-year-old woman suffering from MSA that initially resembled Parkinson's disease with prominent levodopa-induced dyskinesias. DBS of the left internal pallidum was performed in 1998 after a ten-year clinical course and improved dyskinesias. Six months later, the right side was implanted. A few months after the second surgery, the patient progressively developed signs of cerebellar and dysautonomic impairment and MSA was diagnosed.

Conclusion: Our observation confirms the ineffectiveness of DBS of the internal pallidum in MSA and even suggests a harmful effect. DBS remains contra-indicated in atypical parkinsonism.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Deep Brain Stimulation* / adverse effects
  • Dyskinesias / etiology
  • Dyskinesias / therapy
  • Electrodes, Implanted
  • Female
  • Globus Pallidus / physiology*
  • Humans
  • Middle Aged
  • Multiple System Atrophy / therapy*
  • Neurologic Examination
  • Neuropsychological Tests
  • Treatment Failure