title: Pregnancy and Delivery in a Generalized Dystonia Patient Treated with Internal Globus Pallidal Deep Brain Stimulation: a Case Report.
abstract: Internal globus pallidus (GPi) deep brain stimulation (DBS) has been widely accepted as an effective treatment modality of medically refractory dystonia. However, there have been few studies regarding the safety issue of pregnancy and childbirth related with DBS. This report describes a female patient who was pregnant and delivered a baby after GPi DBS surgery. A 33-year-old female patient with acquired generalized dystonia underwent bilateral GPi DBS implantation. She obtained considerable improvement in both movement and disability after DBS implantation. Four years later, she was pregnant and the obstetricians consulted us about the safety of the delivery. At 38-weeks into pregnancy, a scheduled caesarian section was carried out under general anesthesia. After induction using thiopental and succinylcholine, intubation was done quickly, followed by DBS turn off. For hemostasis, only bipolar electrocautery was used. Before awakening from the anesthesia, DBS was turned on as the same parameters previously adjusted. After delivery, she could feed her baby by herself, because the dystonia of left upper extremity and hand was improved. Until now, she has been showing continual improvement and being good at housework, carrying for children, with no trouble in daily life. This observation indicates that the patients who underwent DBS could safely be pregnant and deliver a baby.
authors.affiliation: Department of Neurosurgery, Soonchunhyang University Seoul Hospital, Seoul, Korea.
authors.forename: Hye Ran
authors.identifier: http://orcid.org/0000-0003-0506-4882
authors.initials: HR
authors.lastname: Park
authors.affiliation: Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea.
authors.forename: Jae Meen
authors.identifier: http://orcid.org/0000-0002-5708-1644
authors.initials: JM
authors.lastname: Lee
authors.affiliation: Department of Neurology, Seoul National University Hospital, Seoul, Korea.
authors.forename: Hyeyoung
authors.identifier: http://orcid.org/0000-0003-3504-4612
authors.initials: H
authors.lastname: Park
authors.affiliation: Department of Neurology, Seoul National University Hospital, Seoul, Korea.
authors.forename: Chae Won
authors.identifier: http://orcid.org/0000-0002-4157-492X
authors.initials: CW
authors.lastname: Shin
authors.affiliation: Department of Neurology, Seoul National University Hospital, Seoul, Korea.
authors.forename: Han Joon
authors.identifier: http://orcid.org/0000-0001-8219-9663
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Hee Pyoung
authors.identifier: http://orcid.org/0000-0002-4772-0780
authors.initials: HP
authors.lastname: Park
authors.affiliation: Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea.|Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Dong Gyu
authors.identifier: http://orcid.org/0000-0002-5740-6189
authors.initials: DG
authors.lastname: Kim
authors.affiliation: Department of Neurology, Seoul National University Hospital, Seoul, Korea.|Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Beom Seok
authors.identifier: http://orcid.org/0000-0003-2491-3544
authors.initials: BS
authors.lastname: Jeon
authors.affiliation: Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea.|Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea. paeksh@snu.ac.kr.
authors.forename: Sun Ha
authors.identifier: http://orcid.org/0000-0003-3007-8653
authors.initials: SH
authors.lastname: Paek
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging; D002585:Cesarean Section; D046690:Deep Brain Stimulation; D020821:Dystonic Disorders / Q000175:diagnosis*; D004567:Electrodes, Implanted; D005260:Female; D005917:Globus Pallidus; D006801:Humans; D008279:Magnetic Resonance Imaging; D011247:Pregnancy; D034941:Upper Extremity / Q000503:physiopathology
keywords: Child Birth and Care; Deep Brain Stimulation; Dystonia; Globus Pallidus