Pseudobulbar laughter as a levodopa off phenomenon exacerbated by subthalamic deep brain stimulation.

J Clin Mov Disord

Department of Neurology Division of Movement Disorders, Icahn School of Medicine at Mount Sinai, New York, NY 10029 USA ; Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, 5 East 98th St. First Floor, New York, NY 10029 USA.

Published: January 2016


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Article Abstract

Pseudobulbar affect is a common symptom in neurodegenerative diseases and can also result from lesions in cortical, subcortical and brainstem regions. In Parkinson's disease (PD), pseudobulbar affect (PBA) can occur as a wearing off phenomenon, manifested usually as crying without emotionality. In addition, subthalamic (STN) deep brain stimulation (DBS) has been reported to induce PBA in PD patients with no prior history of such episodes. We present a case of inappropriate laughter lacking mirth as a levodopa OFF phenomenon in a patient with PD, whose laughter also worsened with STN-DBS in his non-medicated state. Levodopa ameliorated his PBA both with and without stimulation. The case demonstrates pseudobulbar laughter as a levodopa OFF phenomenon that is also exacerbated by STN-DBS.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4711012PMC
http://dx.doi.org/10.1186/s40734-015-0023-6DOI Listing

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