La estimulacion cerebral profunda (ECP) es un tratamiento eficaz para pacientes con enfermedad de Parkinson con complicaciones motoras. El elemento más importante que predice la respuesta a la ECP es la respuesta a la levodopa. Mostramos dos casos de pacientes con enfermedad de Parkinson de comienzo precoz con intolerancia severa a la levodopa y excelente respuesta a ECP. La ECP puede ser una alternativa en pacientes parkinsonianos con intolerancia a la levodopa siempre que la respuesta a apomorfina sea positiva.
Deep brain stimulation (DBS) is at present, a useful treatment for patients with advanced Parkinson's disease and motor complications. The crucial step toward consistent DBS outcomes remains careful patient selection; several conditions must be fulfilled including excellent levo dopa response. We report two cases of early onset Parkinson's disease with severe intolerance to levo dopa but excellent and sustained response to DBS. DBS can be a useful alternative for parkinsonian patients with severe intolerance to levo dopa, provided a positive acute response to levo dopa or apomorphine is obtained.
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