title: Rescue pallidotomy for dystonia through implanted deep brain stimulation electrode.
abstract: BACKGROUND
  Some patients with deep brain stimulation (DBS), where removal of implants is indicated due to hardware related infections, are not candidates for later re-implantation. In these patients a rescue lesion through the DBS electrode has been suggested as an option. In this case report we present a patient where a pallidotomy was performed using the DBS electrode.
  
  
  METHODS
  An elderly woman with bilateral Gpi DBS suffered an infection around the left burr hole involving the DBS electrode. A unilateral lesion was performed through the DBS electrode before it was removed. No side effects were encountered. Burke-Fahn-Marsden (BFM) dystonia movement scale score was 39 before DBS. With DBS before lesioning BFM score was 2.5 points. The replacement of the left sided stimulation with a pallidotomy resulted in only a minor deterioration of the score to 5 points.
  
  
  CONCLUSIONS
  In the case presented here a small pallidotomy performed with the DBS electrode provided a satisfactory effect on the patient's dystonic symptoms. Thus, rescue lesions through the DBS electrodes, although off-label, might be considered in patients with Gpi DBS for dystonia when indicated.
authors.affiliation: Department of Pharmacology and Clinical Neuroscience, Umeå University, Sweden.
authors.forename: Patric
authors.initials: P
authors.lastname: Blomstedt
authors.affiliation: Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Takaomi
authors.initials: T
authors.lastname: Taira
authors.affiliation: UCL Institute of Neurology, Queen Square, London, UK.
authors.forename: Marwan
authors.initials: M
authors.lastname: Hariz
keywords: Deep brain stimulation; dystonia; pallidotomy