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High-voltage VIM Region Deep Brain Stimulation Mimicking Progressive Supranuclear Palsy
Addie Patterson1, Michael S Okun1, Christopher Hess1
1Department of Neurology, University of Florida, Gainesville, FL, USA.
Tremor and Other Hyperkinetic Movements (New York, N.Y.)
|April 5, 2017
Summary
Deep brain stimulation (DBS) for essential tremor (ET) can cause side effects mimicking parkinsonism. Reversible symptoms suggest careful consideration of DBS settings and potential misdiagnosis in ET patients.
Area of Science:
- Neurology
- Neurosurgery
Background:
- Deep brain stimulation (DBS) is a treatment for essential tremor (ET).
- DBS can cause unintended side effects.
- Distinguishing DBS side effects from other neurological conditions is crucial.
Purpose of the Study:
- To report a case of essential tremor (ET) patients experiencing parkinsonism-like symptoms due to DBS.
- To highlight the importance of recognizing stimulation-induced side effects.
- To discuss the management of co-occurring ET and Parkinson disease (PD).
Main Methods:
- A patient with essential tremor (ET) received unilateral dual-lead thalamic DBS.
- The patient developed atypical parkinsonism, initially diagnosed as progressive supranuclear palsy.
- DBS inactivation led to symptom resolution, prompting a revised diagnosis.
Main Results:
- DBS inactivation resolved the patient's atypical parkinsonian features.
- The patient was subsequently diagnosed with superimposed idiopathic Parkinson disease (PD).
- This suggests DBS side effects can mimic or unmask other parkinsonian disorders.
Conclusions:
- Recognizing stimulation-induced side effects is vital in DBS management.
- Dual-lead DBS for ET requires careful consideration of potential complications.
- This case underscores the complexity of diagnosing and managing co-existing ET and PD.