OFF–off rebound dyskinesia in subthalamic nucleus deep brain stimulation of Parkinson's disease

Authors

  • Matthew A. Brodsky MD,

    Corresponding author
    1. Department of Neurology, Oregon Health & Science University, and Parkinson's Disease Research, Education & Clinical Care Center, Portland VA Medical Center, Portland, Oregon, USA
    • Parkinson Center of Oregon, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Mailcode OP-32, Portland, OR 97239
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  • Penelope Hogarth MD,

    1. Department of Neurology, Oregon Health & Science University, and Parkinson's Disease Research, Education & Clinical Care Center, Portland VA Medical Center, Portland, Oregon, USA
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  • John G. Nutt MD

    1. Department of Neurology, Oregon Health & Science University, and Parkinson's Disease Research, Education & Clinical Care Center, Portland VA Medical Center, Portland, Oregon, USA
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Abstract

A 61-year-old man with Parkinson's disease (PD), motor fluctuations, and dyskinesias underwent bilateral implantation of deep brain stimulation (DBS) electrodes in the subthalamic nucleus (STN). One month after surgery, DBS was optimized to bilateral monopolar settings at the most proximal electrode just superior to the STN, which improved motor fluctuations and dyskinesias. At several postoperative evaluations off medications overnight, both stimulators were turned off and within 60 seconds he developed severe dyskinesias. When the stimulators were turned back on, the dyskinesias soon resolved. This article is a first report of a unique pattern of rebound-type dyskinesia that occurred in the off medication state produced by stopping STN DBS. © 2006 Movement Disorder Society

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