Turkish Neurosurgery 2017 , Vol 27 , Num 2
Unilateral Subthalamic Nucleus Stimulation in the Treatment of Asymmetric Parkinson"s Disease with Early Motor Complications
Michal SOBSTYL1,Miroslaw ZABEK1,Artur ZACZYNSKI2,Wojciech GORECKI2,Zbigniew MOSSAKOWSKI2,Grazyna BRZUSZKIEWICZ-KUZMICKA3, ,
1Postgraduate Medical Center, Department of Neurosurgery, Warsaw, Poland
2Bródno Regional Hospital, Department of Neurosurgery, Warsaw, Poland
3Józef Pi?sudski University of Physical Education, Faculty of Rehabilitation, Warsaw, Poland
DOI : 10.5137/1019-5149.JTN.14894-15.0 AIM: The aim of this study was to assess the results of unilateral subthalamic nucleus (STN) stimulation for the treatment of Parkinson"s disease (PD) with marked asymmetry of parkinsonian motor symptoms and early motor complications.

MATERIAL and METHODS: The clinical series consisted of 32 consecutive PD patients, in whom unilateral STN stimulation was performed. All patients were assessed according to the Unified Parkinson"s Disease Rating Scale (UPDRS), and Hoehn and Yahr staging. The patients were assessed preoperatively, and at 12, and 24 months after unilateral STN stimulation. 22 patients were followed for 2 years.

RESULTS: Medication off/stimulation on total UPDRS motor scores were improved by 29% when compared to the baseline medication off motor scores. The contralateral motor scores improved by 49%, whereas the axial motor scores by 18% in medication off/stimulation on condition. The duration and severity of levodopa induced dyskinesia were reduced respectively by 73% and by 77%. The daily levodopa dose was decreased by only 10%.

CONCLUSION: Unilateral STN stimulation is a safe and effective procedure for selected patients with marked asymmetry Parkinson"s disease motor symptoms and early motor complications. Keywords : Deep brain stimulation, Unilateral subthalamic nucleus stimulation, Neuronavigation, Stereotactic neurosurgery