Subthalamic stimulation improves levodopa responsive symptoms in a case of progressive supranuclear palsy

A case is described of a patient with levodopa responsive parkinsonism, dyskinesia, and off periods who underwent bilateral deep brain stimulation of the subthalamic nuclei (DBS-STN) with good result. As the disease progressed, the patient fit diagnostic criteria for progressive supranuclear palsy parkinsonism (PSP-P). Benefit of DBS for the parkinsonian phenomena is still apparent 4 years later. That DBS-STN provided targeted symptom relief in this unusual patient suggests that the parkinsonism of PSP-P and that of Parkinson's disease (PD) may share a common pathophysiologic mechanism. The presence of dystonic features in this illness raises the possibility that the globus pallidus might also have been an effective target. (c) 2007 Elsevier Ltd. All rights reserved.