Subthalamic nucleus stimulation improves directly levodopa induced dyskinesias in Parkinson’s disease

At the age of 56 he developed a peak of dose choreiform dyskinesias in the trunk and limbs and 2 years later he also had motor fluctuations of the wearing off type. Since 1993, the patient had severe generalised choreiform dyskinesias that were present for about 75% of the diurnal time. Unilateral STN stimulation induces hemiballism in healthy monkeys 3 and improves all parkinsonian symptoms, 1 including levodopa induced dyskinesias, in patients with Parkinson's disease. 2 Although the improvement of levodopa induced dyskinesias has been attributed by Krack et al 2 to the decrease of levodopa dosage, our patient showed a marked improvement after surgery despite the fact that the levodopa dose could not be decreased after optimising the antiparkinsonian therapy.