Tommasi Giorgio, Lopiano Leonardo, Zibetti Maurizio, Cinquepalmi Annina, Fronda Chiara, Bergamasco Bruno, Ducati Alessandro, Lanotte Michele
Institute of Neurology, Department of Neurosciences, University of Turin, Italy.
J Neurol Sci. 2007 Jul 15;258(1-2):99-103. doi: 10.1016/j.jns.2007.03.002. Epub 2007 Apr 19.
We report a case of a Parkinson's disease patient treated by bilateral deep brain stimulation of the subthalamic nucleus, who developed freezing and hypokinesia of gait induced by stimulation through a left-side misplaced electrode which was more antero-medial than the planned trajectory. Subsequently, correct repositioning of the left electrode afforded complete relief of gait disturbances. Freezing and hypokinesia of gait may be side effects of deep brain stimulation of the subthalamic region due to current spreading antero-medially to the subthalamic nucleus. These side effects are not subject to habituation and restrict any increase in stimulation parameters. We hypothesize that pallidal projections to the pedunculopontine nucleus could be responsible for these gait disturbances in our patient.
我们报告了一例帕金森病患者，该患者接受了双侧丘脑底核深部脑刺激治疗，因左侧电极位置不当（比计划轨迹更靠前内侧）刺激引发了步态冻结和运动迟缓。随后，将左侧电极正确重新定位后，步态障碍完全缓解。步态冻结和运动迟缓可能是丘脑底区深部脑刺激的副作用，原因是电流向前内侧扩散至丘脑底核。这些副作用不会产生适应性，并且限制了刺激参数的任何增加。我们推测，苍白球向脚桥核的投射可能是导致该患者出现这些步态障碍的原因。
