Lesion of thalamic centromedian--parafascicular complex after chronic deep brain stimulation.
A patient with PD who exhibited disabling tremor and prominent dyskinesia underwent deep brain stimulation (DBS) of the left thalamic ventral intermediate nucleus. The electrode migrated and was replaced but with suboptimal clinical response. Two years later, postmortem analysis found the second electrode tip had entered the thalamic centromedian-parafascicular complex. There was a small thalamotomy and cell loss exceeding that found in PD. Thalamic damage may occur in association with DBS for PD.
Henderson
J M
JM
Neuropathology Laboratory, Prince of Wales Medical Research Institute, Randwick, NSW, Australia. j.henderson@unsw.edu.au
O'Sullivan
D J
DJ
Pell
M
M
Fung
V S
VS
Hely
M A
MA
Morris
J G
JG
Halliday
G M
GM
D002908:Chronic Disease; D004599:Electric Stimulation Therapy / Q000009:adverse effects*; D004567:Electrodes, Implanted / Q000009:adverse effects*; D017809:Fatal Outcome; D005548:Foreign-Body Migration / Q000473:pathology; D006801:Humans; D020646:Intralaminar Thalamic Nuclei / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000473:pathology*