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dc.contributor.author
Merello, Marcelo Jorge
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dc.contributor.author
Perez Lloret, Santiago
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dc.contributor.author
Antico, J.
dc.contributor.author
Obeso, J. A.
dc.date.available
2024-08-14T12:23:27Z
dc.date.issued
2006-12
dc.identifier.citation
Merello, Marcelo Jorge; Perez Lloret, Santiago; Antico, J. ; Obeso, J. A.; Dyskinesias induced by subthalamotomy in Parkinson's disease are unresponsive to amantadine; B M J Publishing Group; Neuropsychiatry Of Basal Ganglia; 77; 2; 12-2006; 172-174
dc.identifier.issn
0022-3050
dc.identifier.uri
http://hdl.handle.net/11336/242490
dc.description.abstract
Background: Dyskinesias are a transient but severe complication of subthalamotomy in some patients. Patients and methods: Three patients with Parkinson’s disease undergoing bilateral micro-recording guided surgery of the subthalamic nucleus (STN) are described; deep brain stimulation (DBS) was used in one case, and subthalamotomy in the other two. Prior to surgery, levodopa induced dyskinesia had improved (⩽50%) under treatment with amantadine (400 mg/day, po) in all three patients. The patient treated with DBS developed severe dyskinesia a few days after discharge and began self medication with amantadine but showed no improvement. This suggested a possible lack of response to amantadine for treatment of dyskinesias induced by surgery of the STN. Results: Both patients treated with bilateral subthalamotomy developed unilateral choreoballistic movements immediately after surgery, despite not taking levodopa (L-dopa). Patients were scored using the dyskinesia scale and started treatment with 400 mg amantadine (po) for 4 days within the first postoperative week with no effect on dyskinesia score or its phenomenology. Amantadine was therefore discontinued. One month after surgery both patients were free of involuntary movements with an improvement of about 60% in the “off” state UPDRS motor score. Six month follow up showed maintained antiparkinsonian benefit, without need for levodopa treatment and complete absence of dyskinesia. Conclusion: The present findings suggest that: (i) amantadine probably exerts its anti-dyskinetic effect by acting on the “indirect” pathway; (ii) the pathophysiological mechanisms of subthalamotomy induced dyskinesias may differ from those involved in L-dopa induced dyskinesias; (iii) dyskinesias induced by STN surgery resolve spontaneously as compensatory mechanisms develop.
dc.format
application/pdf
dc.language.iso
eng
dc.publisher
B M J Publishing Group
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dc.rights
info:eu-repo/semantics/openAccess
dc.rights.uri
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.subject
PARKINSON
dc.subject.classification
Neurología Clínica
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dc.subject.classification
Medicina Clínica
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dc.subject.classification
CIENCIAS MÉDICAS Y DE LA SALUD
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dc.title
Dyskinesias induced by subthalamotomy in Parkinson's disease are unresponsive to amantadine
dc.type
info:eu-repo/semantics/article
dc.type
info:ar-repo/semantics/artículo
dc.type
info:eu-repo/semantics/publishedVersion
dc.date.updated
2024-08-05T13:50:18Z
dc.journal.volume
77
dc.journal.number
2
dc.journal.pagination
172-174
dc.journal.pais
Reino Unido
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dc.journal.ciudad
Londres
dc.description.fil
Fil: Merello, Marcelo Jorge. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
dc.description.fil
Fil: Perez Lloret, Santiago. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
dc.description.fil
Fil: Antico, J.. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; Argentina
dc.description.fil
Fil: Obeso, J. A.. Universidad de Navarra; España
dc.journal.title
Neuropsychiatry Of Basal Ganglia
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dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/url/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2077561/
dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/url/https://jnnp.bmj.com/content/77/2/172.long
dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/doi/http://dx.doi.org/10.1136/jnnp.2005.068940
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