title: Smile without euphoria induced by deep brain stimulation: a case report.
abstract: Poststroke central pain (PSCP) can be a debilitating medication-refractory disorder. We report a single case where right unilateral ventral capsule/ventral striatum (VC/VS) deep brain stimulation was used to treat PSCP and inadvertently induced a smile without euphoria. The patient was a 69 year-old woman who had a stroke with resultant dysesthesia and allodynia in her left hemibody and also a painful left hemibody dystonia. In her case, VC/VS stimulation induced a smile phenomenon, but without a euphoric sensation. This phenomenon was different from the typical smile responses we have observed in obsessive-compulsive disorder cases. This difference was considered to be possibly attributable to impairment in the emotional smile pathway.
authors.affiliation: a Department of Neurosurgery , Center for Movement Disorders and Neurorestoration, McKnight Brain Institute, University of Florida College of Medicine , Gainesville , FL , USA.
authors.forename: Takashi
authors.initials: T
authors.lastname: Morishita
authors.forename: Kelly D
authors.initials: KD
authors.lastname: Foote
authors.forename: Derek B
authors.initials: DB
authors.lastname: Archer
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Coombes
authors.forename: David E
authors.initials: DE
authors.lastname: Vaillancourt
authors.forename: Anhar
authors.initials: A
authors.lastname: Hassan
authors.forename: Ihtsham U
authors.initials: IU
authors.lastname: Haq
authors.forename: Janine
authors.initials: J
authors.lastname: Wolf
authors.forename: Michael S
authors.initials: MS
authors.lastname: Okun
mesh_terms: D000368:Aged; D046690:Deep Brain Stimulation; D005059:Euphoria / Q000502:physiology*; D005260:Female; D006801:Humans; D020772:Internal Capsule / Q000503:physiopathology* / Q000601:surgery; D010146:Pain / Q000209:etiology / Q000503:physiopathology; D059408:Pain Management; D012904:Smiling / Q000502:physiology*; D020521:Stroke / Q000150:complications; D066328:Ventral Striatum / Q000503:physiopathology* / Q000601:surgery
keywords: chronic pain; deep brain stimulation; smile; ventral capsule; ventral striatum