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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. 76 year old man

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Management of Advanced Parkinsons Disease With Spinal Cord Stimulation

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  1. 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

  2. Case Report • 76 year old man • 10 year history of PD with intractable dyskinesias in upper extremities • Declined DBS

  3. Stimulation Demonstration #1

  4. Two 8-electrode Epidural Leads RestoreULTRA Generator (Medtronic Inc.)

  5. 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)

  6. 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

  7. Stimulation Demonstration #2

  8. 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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