Background:
Leva-dopa (L-dopa) is the gold-standard treatment for Parkinson's disease (PD). Deep brain stimulation is generally reserved for patients who become refractory to l-dopa treatment.
Case description:
We present a male patient with a 9-year course of PD who at 53 years of age preferred deep brain stimulation (DBS) of the subthalamic nucleus over initial l-dopa treatment. The patient argued that he wanted to avoid the serious adverse effects of l-dopa, which would have presented within his time of full professional activity. DBS resulted in significant motor improvement lasting for 6 years without l-dopa treatment.
Conclusion:
Large multicentre-based international trials with long follow-ups are needed to answer the effectiveness of early DBS in PD.