Further experience with extradural motor cortex stimulation for treatment of advanced Parkinson's disease. Report of 3 new cases.

AIM

To report the results obtained with the extradural motor cortex stimulation in Parkinson's disease.

METHODS

Three patients were submitted to MRI images and functional MRI in order to identify the upper limb motor area. Then a quadripolar electrostimulator was introduced in the extradural space, through 2 burr holes.

RESULTS

Unilateral, extradural motor cortex stimulation relieves, at least partially, but sometime dramatically, the whole spectrum of symptoms in advanced Parkinson disease: tremor and rigor bilaterally in all limbs; akinesia; standing, anteropulsion, gait; motor performance; dysphagia; speech and swallowing. Also the symptoms of long term dopa syndrome--dyskinesias, and other secondary effect of L-dopa administration, psychiatric symptoms--are improved.

CONCLUSION

The results seems do not fade away with time. Drug dosage may be reduced by 50%. We suggest early employ of transdural motor cortex stimulation.