Cerebral ischemia related to globus pallidus internus stimulation for cervical dystonia

Dong Wan Kang, Hae Yu Kim, Jin Woo Chang

Research output: Contribution to journalReview article

7 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)201-204
Number of pages4
JournalStereotactic and functional neurosurgery
Volume89
Issue number4
DOIs
Publication statusPublished - 2011 Aug 1

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Torticollis
Globus Pallidus
Deep Brain Stimulation
Brain Ischemia
Ischemia
Internal Capsule
Dysarthria
Cerebral Infarction
Movement Disorders
Microelectrodes
Paresis
Electric Stimulation
Magnetic Resonance Imaging
Hemorrhage
Infection

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

Cite this

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title = "Cerebral ischemia related to globus pallidus internus stimulation for cervical dystonia",
abstract = "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.",
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Cerebral ischemia related to globus pallidus internus stimulation for cervical dystonia. / Kang, Dong Wan; Kim, Hae Yu; Chang, Jin Woo.

In: Stereotactic and functional neurosurgery, Vol. 89, No. 4, 01.08.2011, p. 201-204.

Research output: Contribution to journalReview article

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AB - 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.

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