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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

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
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
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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