Turkish Neurosurgery
Subthalamic nucleus deep brain stimulation in a patient with severe axial symptoms and suboptimal levodopa responsive Parkinson’s disease
Behrad Nassehi1, Taha Assadnejad1, Onur Yildiz 2, Dursun Aygun 3, Ersoy Kocabicak4
1Ondokuz Mayis University Medicine Faculty, Neuromodulation Center, Samsun,
2Erzurum Regional Health Application and Research Hospital, Neurology, Erzurum,
3Ondokuz Mayıs University, Neurology, Samsun,
4Ondokuz Mayıs University, Neurosurgery, Samsun,
DOI: 10.5137/1019-5149.JTN.35424-21.3

Background: Deep brain stimulation (DBS) is a well-established treatment option for improving function and quality of life in carefully selected patients with Parkinson’s disease (PD). Patient selection is a crucial step that should be carried out by an experienced multidisciplinary team according to the proposed inclusion and exclusion criteria to increase the quality of life (QoL) of patients. Case: A 47-year-old bedridden woman with a 20-year history of PD presented with levodopa-unresponsive tremor and severe axial symptoms. Despite various antiparkinsonian medications, a suboptimal improvement was observed with the levodopa challenge test. After detailed evaluations, she underwent bilateral Subthalamic nucleus DBS (STN-DBS). During 2-year-follow-up her axial symptoms improved significantly leading to a better QoL. Conclusion: Although levodopa-resistant axial symptoms are considered a relative contraindication to DBS surgery, this case report demonstrates that with an interdisciplinary approach and an accurate assessment of symptoms, even bedridden and late-stage selected PD cases may benefit from DBS.

Corresponding author : Ersoy Kocabicak