Management of advanced parkinsons disease with spinal cord stimulation
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Management of Advanced Parkinsons Disease With Spinal Cord Stimulation. Alexander E. Yakovlev MD Sergey A. Karasev MD Beth E. Resch APNP Comprehensive Pain Management of The Fox Valley SC, Appleton, WI. Case Report. 76 year old man

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Management of Advanced Parkinsons Disease With Spinal Cord Stimulation

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Management of advanced parkinsons disease with spinal cord stimulation

Management of Advanced Parkinsons Disease With Spinal Cord Stimulation

Alexander E. Yakovlev MD

Sergey A. Karasev MD

Beth E. Resch APNP

Comprehensive Pain Management of

The Fox Valley SC, Appleton, WI


Case report

Case Report

  • 76 year old man

  • 10 year history of PD with intractable dyskinesias in upper extremities

  • Declined DBS


Stimulation demonstration 1

Stimulation Demonstration #1


Two 8 electrode epidural leads restoreultra generator medtronic inc

Two 8-electrode Epidural Leads RestoreULTRA Generator (Medtronic Inc.)


Stimulator parameters

Stimulator Parameters:

  • Pulse width 210 microseconds

  • Frequency 20 Hz

  • Amplitude use ranged from 0.5-0.6 volts at sub-threshold level

  • Electrode polarities:

    First lead 0(off) 1(+) 2(-) 3(+) 4 (-) 5(+) 6(off) 7(off)

    Second lead 8(off) 9(off) 10(+) 11(-) 12(+) 13(-) 14(+) 15(0ff)


Results

Results:

  • Sustained control of dyskinesias and dystonia

  • Unified Parkinson’s disease rating scale (UPDRS)III

    motor score was reduced from 33 to 12

  • Stimulation conducted continuously, for 24 hr per day

  • Improved functional status

  • Return to social activities, improved family relationships

  • No complications or side effects


Stimulation demonstration 2

Stimulation Demonstration #2


Conclusions

Conclusions:

  • Effective option for patients with advanced Parkinson disease

  • Potential alternative to pharmacological treatment

  • Consider for patients who defer surgical treatment including DBS

  • The therapy is reversible

  • Excellent option for patients with co-morbidities


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