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The periaqueductal/periventricular grey area (PAG/PVG) is a midbrain nucleus with an important role in pain signalling and autonomic control. We present the case of an initially hypertensive man who developed a presumed neurodegenerative disorder over a decade, characterised by progressive right-sided chronic pain, extra-pyramidal symptoms and autonomic dysfunction including postural hypotension, sleep apnoea, and bladder instability. He underwent a variety of treatments for his symptoms, including deep brain stimulation (DBS) of the PAG/PVG. 24-h blood pressure monitoring was carried out 1 and 5 years after implantation. Although the DBS initially produced a significant reduction in blood pressure, the effect was significantly reversed when the same tests were repeated 5 years after surgery. This may imply a functional involvement of the PAG/PVG in the neurodegenerative process.

Original publication

DOI

10.1007/s10286-013-0206-x

Type

Journal article

Journal

Clin Auton Res

Publication Date

08/2013

Volume

23

Pages

215 - 219

Keywords

Antiparkinson Agents, Blood Pressure, Blood Pressure Monitoring, Ambulatory, Deep Brain Stimulation, Electrodes, Implanted, Female, Humans, Middle Aged, Multiple System Atrophy, Neurodegenerative Diseases, Neurosurgical Procedures, Periaqueductal Gray, Treatment Outcome, Tremor