Dramatic psychiatric and behavioral symptoms following a subthalamic lesion

Area of Science:

• Neuroscience
• Neurology
• Psychiatry

Background:

• Neuropsychiatric symptoms are common after subthalamic nucleus deep brain stimulation (STN-DBS).
• However, neuropsychiatric symptoms following a subthalamic lesion are rarely documented.

Observation:

• A 43-year-old woman presented with sudden, severe psychiatric and behavioral symptoms alongside hemiballism.
• Brain MRI revealed extensive hyperintensity in the left subthalamic nucleus (STN) and surrounding areas during the acute phase.

Findings:

• The patient experienced dramatic neuropsychiatric symptoms and hemiballism due to a subthalamic lesion.
• Symptoms gradually improved with steroid and symptomatic treatment, with no abnormal enhancement on contrast-enhanced MRI or significant findings in routine tests.

Implications:

• This case underscores that significant neuropsychiatric symptoms can arise from subthalamic lesions.
• Recognizing and managing these symptoms is crucial for patient care and treatment strategies.