Differential diagnosis of psychiatric symptoms after deep brain stimulation for movement disorders
Davin K Quinn1, Amanda Deligtisch, Caleb Rees
1Department of Psychiatry, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.
Objectives:
The presence of a deep brain stimulator (DBS) in a patient with a movement disorder who develops psychiatric symptoms poses unique diagnostic and therapeutic challenges for the treating clinician. Few sources discuss approaches to diagnosing and treating these symptoms.
Materials And Methods:
The authors review the literature on psychiatric complications in DBS for movement disorders and propose a heuristic for categorizing symptoms according to their temporal relationship with the DBS implantation process.
Results:
Psychiatric symptoms after DBS can be categorized as preimplantation, intra-operative/perioperative, stimulation related, device malfunction, medication related, and chronic stimulation related/long term. Once determined, the specific etiology of a symptom guides the practitioner in treatment.
Conclusions:
A structured approach to psychiatric symptoms in DBS patients allows practitioners to effectively diagnose and treat them when they arise.
