Deep Brain Stimulation in Multiple System Atrophy Mimicking Idiopathic Parkinson's Disease

• Main Authors: Navamayooran Thavanesan, Martin Gillies, Michael Farrell, Alex L. Green, Tipu Aziz
• Format: Article
• Language: English
• Published: Karger Publishers 2014-10-01
• Series: Case Reports in Neurology
• Subjects: Deep brain stimulation; Multiple system atrophy; Idiopathic Parkinson’s disease
• Online Access: http://www.karger.com/Article/FullText/368571

Deep brain stimulation (DBS) is approved for idiopathic Parkinson's disease (IPD) but has a poor evidence base in Parkinson-plus syndromes such as multiple system atrophy (MSA). We describe the clinical and neuropathological findings in a man who was initially diagnosed with IPD, in whom DBS was unsuccessful, and in whom MSA was unexpectedly diagnosed at a subsequent autopsy. This case report highlights that DBS is often unsuccessful in MSA and also demonstrates that MSA can masquerade as IPD, which may explain treatment failure in a small group of patients apparently suffering from Parkinson's disease. Additionally, it also presents a case with an unusually long duration of disease prior to death, comparable only to a handful of other cases in the literature.