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Globus pallidus interna deep brain stimulation for tardive dyskinesia: Case report and review of the literature.
MedLine Citation:
PMID:  23099106     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Tardive dyskinesia (TD) can be a disabling condition and is frequently refractory to medical therapy. Over the past decade there have been many reports of TD patients experiencing significant benefit with deep brain stimulation (DBS) of the globus pallidus interna (GPi). The growing literature on this treatment option for TD consists predominantly of case reports and series. The reported benefit ranges widely, but the majority of cases experienced at least a 50% improvement in symptoms. The anatomical distribution of dyskinesias has not clearly influenced outcome, though fixed postures appear less likely to improve than phasic movements. Onset of benefit can be immediate or take months, and benefit is sustained in most cases, for at least 6 months and up to several years. A wide variety of voltages, frequencies, and pulse widths have demonstrated efficacy. A small number of reports which examined psychiatric symptoms before and after surgery did not find any decline, and in some cases revealed improvement in mood. However, these overall positive results should be interpreted with caution, as the majority of reports lacked blinded assessments, control groups, or standardized therapy parameters. Finally, we present an illustrative case of refractory tardive dyskinesia treated with GPi-DBS with 5 years of follow-up and 4 accompanying video segments.
Authors:
Meredith A Spindler; Nicholas B Galifianakis; Jayne R Wilkinson; John E Duda
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-22
Journal Detail:
Title:  Parkinsonism & related disorders     Volume:  -     ISSN:  1873-5126     ISO Abbreviation:  Parkinsonism Relat. Disord.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9513583     Medline TA:  Parkinsonism Relat Disord     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Published by Elsevier Ltd.
Affiliation:
Parkinson's Disease Research, Education and Clinical Center (PADRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA; Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
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