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Updated: Jun 1, 2026
Measurement & Analysis of the Temporal Discrimination Threshold Applied to Cervical Dystonia
Published on: January 27, 2018
Cerebral ischemia related to globus pallidus internus stimulation for cervical dystonia
Dong Wan Kang1, Hae Yu Kim, Jin Woo Chang
1Department of Neurosurgery, Yonsei University School of Medicine, Seoul, Republic of Korea.
Background:
Deep brain stimulation (DBS) is generally a safe and effective method to treat intractable movement disorders. However, complications of surgery have been reported, such as hemorrhage, infection and hardware failure.
Objectives And Methods:
We describe an unusual complication associated with DBS of the globus pallidus internus (GPi). The patient was a 34-year-old man with a 5-year history of progressive cervical dystonia that was unresponsive to medical treatment. He underwent bilateral DBS of the posteroventral GPi. After test stimulation, the patient developed left facial weakness, as well as dysarthria and hemiparesis of the left side. Magnetic resonance imaging showed a small infarct in the right posterior internal capsule. There was no misplacement of the microelectrode.
Results And Conclusion:
The authors present this unique case of cerebral infarction as a complication of DBS. The mechanism of ischemia is unclear. However, in this case, we had performed microstimulation with high amplitude in order to determine the adverse effects. This magnitude of electrical stimulation may have led to small-vessel vasospasm, which may have induced ischemia. Although ischemia after DBS surgery is seldom reported, cerebral ischemia may be a surgical complication after DBS implantation.
Insights
Deep brain stimulation (DBS) for cervical dystonia can rarely cause cerebral infarction. High-amplitude microstimulation during DBS surgery may lead to vasospasm and ischemic stroke.
Area of Science:
- Neurology
- Neurosurgery
- Medical Devices
Background:
- Deep brain stimulation (DBS) is a common treatment for movement disorders.
- While generally safe, DBS surgery carries risks like hemorrhage, infection, and hardware issues.
Observation:
- A 34-year-old man with intractable cervical dystonia underwent bilateral DBS of the globus pallidus internus (GPi).
- Post-stimulation, he experienced left-sided facial weakness, dysarthria, and hemiparesis.
Findings:
- MRI revealed a small infarct in the right posterior internal capsule.
- No microelectrode misplacement was identified, suggesting the complication arose from the stimulation itself.
Implications:
- This case highlights cerebral infarction as a rare but potential complication of DBS surgery.
- High-amplitude microstimulation might induce vasospasm, leading to ischemia, warranting careful parameter selection.
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