Stimulation-induced parkinsonism after posteroventral deep brain stimulation of the globus pallidus internus for craniocervical dystonia.
The authors report on a patient with craniocervical dystonia who was treated with bilateral GPi stimulation, with excellent improvement in dystonia but at the cost of stimulation-induced, reversible parkinsonism. Stimulation through ventral contacts resulted in maximal relief of craniocervical dystonia but induced considerable hypophonia, bradykinesia, rigidity, freezing, and impaired postural reflexes. Stimulation through dorsal contacts alleviated parkinsonism, but resulted in the return of dystonia. No stimulation parameters could alleviate the dystonia without inducing parkinsonism over the course of his 4-year follow-up.
Zauber
S Elizabeth
SE
Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA.
Watson
Nidhi
N
Comella
Cynthia L
CL
Bakay
Roy A E
RA
Metman
Leo Verhagen
LV
D000328:Adult; D001764:Blepharospasm / Q000503:physiopathology / Q000628:therapy*; D001931:Brain Mapping; D046690:Deep Brain Stimulation / Q000009:adverse effects*; D004292:Dominance, Cerebral / Q000502:physiology; D004401:Dysarthria / Q000209:etiology / Q000503:physiopathology; D005500:Follow-Up Studies; D005917:Globus Pallidus / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008839:Microelectrodes; D009048:Motor Skills / Q000502:physiology; D009460:Neurologic Examination; D020734:Parkinsonian Disorders / Q000209:etiology* / Q000503:physiopathology; D011183:Postoperative Complications / Q000209:etiology* / Q000503:physiopathology; D014103:Torticollis / Q000503:physiopathology / Q000628:therapy*