Mood disorder following DBS of the left amygdaloid region in a dystonia patient with a dislodged electrode.
Continuous high-frequency stimulation of the globus pallidum internum (GPi) is an accepted treatment for patients with primary dystonia. In a series of 18 consecutive dystonia cases that were successfully treated by bilateral GPi stimulation, 1 patient had an adverse event involving the downward migration of the electrodes. He developed remarkable behavioral complications and was found to have dislodgement of the left electrode to a position close to the left amygdala. The patient developed behavioral changes consisting of depression, psychotic symptoms, and heightened pain perception. This syndrome reverted when the left electrode was removed and a new one inserted in the correct position. We describe in detail the clinical features associated with left amygdala dysregulation induced by high-frequency stimulation through the displaced electrode.
Piacentini
Sylvie
S
Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy.
Romito
Luigi
L
Franzini
Angelo
A
Granato
Alberto
A
Broggi
Giovanni
G
Albanese
Alberto
A
D000328:Adult; D000679:Amygdala; D046690:Deep Brain Stimulation / Q000009:adverse effects*; D004421:Dystonia / Q000628:therapy*; D004567:Electrodes, Implanted; D004868:Equipment Failure; D007839:Functional Laterality / Q000502:physiology*; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology*