Freezing and hypokinesia of gait induced by stimulation of the subthalamic region.
We report a case of a Parkinson's disease patient treated by bilateral deep brain stimulation of the subthalamic nucleus, who developed freezing and hypokinesia of gait induced by stimulation through a left-side misplaced electrode which was more antero-medial than the planned trajectory. Subsequently, correct repositioning of the left electrode afforded complete relief of gait disturbances. Freezing and hypokinesia of gait may be side effects of deep brain stimulation of the subthalamic region due to current spreading antero-medially to the subthalamic nucleus. These side effects are not subject to habituation and restrict any increase in stimulation parameters. We hypothesize that pallidal projections to the pedunculopontine nucleus could be responsible for these gait disturbances in our patient.
Tommasi
Giorgio
G
Institute of Neurology, Department of Neurosciences, University of Turin, Italy.
Lopiano
Leonardo
L
Zibetti
Maurizio
M
Cinquepalmi
Annina
A
Fronda
Chiara
C
Bergamasco
Bruno
B
Ducati
Alessandro
A
Lanotte
Michele
M
D000368:Aged; D046690:Deep Brain Stimulation / Q000009:adverse effects*; D046352:Freezing Reaction, Cataleptic / Q000528:radiation effects*; D007839:Functional Laterality; D006801:Humans; D018476:Hypokinesia / Q000209:etiology*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D010300:Parkinson Disease / Q000473:pathology* / Q000601:surgery; D020531:Subthalamic Nucleus / Q000601:surgery*