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At 06:02 1999/08/25 -0400, you wrote: >Fellow Parkinsonians: > >I'd like comments from anyone who has had brain stimulation of the >subthalamic nucleus (both sides). I'm particularly interested in the >experiences of individuals who had already had a pallidotomy. > >I'm also curious about experiences people might have had at Kansas >University Medical Center in Kansas City, KA, > >Joan Holliday joan this abstract is on the wwweb at the journal's site i have requested a copy of the complete article from the journal's office there may be more abstracts like this in PubMed janet Pallidal Stimulation in Parkinson's Disease Patients with a Prior Unilateral Pallidotomy Objective: To evaluate, in a double-blind fashion, the efficacy of deep brain stimulation of the internal segment of the globus pallidus (GPi) contralateral to a previous unilateral medial pallidotomy (MP). Methods: This pilot study involved 4 patients with a previous MP and one previously unoperated patient unable to tolerate any antiparkinsonian drugs. One of the patients with a prior unilateral MP had two electrodes implanted in the contralateral side, one in GPi and one in Vim thalamus. Detailed neurologic assessments were performed after overnight drug withdrawal and in the drug "on" state at baseline, 1 week and 3 months (in all), and 9 and 12 months (one) with patients and evaluators blinded to the status of stimulation. Results: GPi stimulation resulted in improvements in "off-period" contralateral bradykinesia, rigidity and tremor in all patients. Dyskinesias and freezing episodes were ameliorated in one patient each but dyskinesias were transiently induced in another. The patient with GPi+Vim electrodes had complete resolution of contralateral tremor with thalamic stimulation but less benefit from acute GPi stimulation. One patient experienced a single seizure one week post-op and no other surgical complications were observed. Conclusions: Deep brain stimulation can be applied safely and effectively in patients who have already had a pallidotomy on the contralateral side. The effect of stimulation at different sites on different symptom profiles and levodopa-induced dyskinesias requires further evaluation. Can. J. Neurol. Sci. 1998; 25: 300-305 Volume 25 No 4, November 1998 Néstor Gálvez-Jiménez, Andres Lozano , Ronald Tasker, Janice Duff, William Hutchison and Anthony E. Lang <http://www.canjneurolsci.org/25novtoc/pallidal.html> janet paterson 52 now / 41 dx / 37 onset po box 171, almonte, ontario, canada, K0A 1A0 a new voice: http://www.geocities.com/SoHo/Village/6263/ [log in to unmask]