Hostname: page-component-54dcc4c588-sdd8f Total loading time: 0 Render date: 2025-10-12T07:46:20.406Z Has data issue: false hasContentIssue false
  • English
  • Français

Severe agitation following deep brain stimulation for parkinsonism

Published online by Cambridge University Press:  11 May 2015

Nicholas G.W. Rose ,
Michael Mostrenko ,
Jacqueline McMaster  and
Christopher R. Honey
Nicholas G.W. Rose*
Affiliation:
Department of Emergency Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, BC
Michael Mostrenko
Affiliation:
Department of Emergency Medicine, Royal Columbian Hospital, New Westminster, BC
Jacqueline McMaster
Affiliation:
Division of Neurosurgery, Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC
Christopher R. Honey
Affiliation:
Division of Neurosurgery, Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC
*
Department of Emergency Medicine, Vancouver General Hospital, 855 West 12th Avenue, Vancouver, BC; nrose@interchange.ubc.ca

Abstract:

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

The use of deep brain stimulation has become increasingly common for the treatment of movement disorders, including Parkinson disease. Although deep brain stimulation is generally very successful in alleviating the extrapyramidal symptoms of Parkinson disease, side effects can occur. This case report describes a patient presenting to the emergency department in a state of extreme aggression 3 days after a change in the parameters of his bilateral subthalamic nucleus stimulator. We review the complications of deep brain stimulation relevant to the emergency physician and provide some practical information on stimulator adjustment in an emergency.

Keywords

complicationsdeep brain stimulationParkinson diseasesubthalamic nucleus

Information

Type
Case Report • Rapport de cas
Information
Canadian Journal of Emergency Medicine , Volume 13 , Issue 4 , July 2011 , pp. 279 - 283
Copyright
Copyright © Canadian Association of Emergency Physicians 2011

References

REFERENCES

1.Deuschel, G, Schade-Brittinger, C, Krack, P, et al. A randomized trial of deep-brain stimulation for Parkinson’s disease. N Engl J Med 2006;355:896–908.CrossRefGoogle Scholar
2.Hallett, MM, Litvan, I. Evaluation of surgery for Parkinson’s disease: a report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. The Task Force on Surgery for Parkinson’s Disease. Neurology 1999;53:1910–21.Google Scholar
3.Mayberg, H, Lozano, A, Voon, V, et al. Deep brain stimulation for treatment-resistant depression. Neuron 2005;45:651–60.Google Scholar
4.Servello, D, Porta, M, Sassi, M, et al. Deep brain stimulation in 18 patients with severe Gilles de la Tourette syndrome refractory to treatment: the surgery and stimulation. J Neurol Neurosurg Psychiatry 2008;79:136–42.CrossRefGoogle ScholarPubMed
5.Theodore, W, Fisher, R. Brain stimulation for epilepsy. Lancet Neurol 2004;3:111–8.CrossRefGoogle ScholarPubMed
6.Seijo, FJ, Alvarez-Vega, MA, Gutierrez, JC, et al. Complications in subthalamic nucleus stimulation surgery for treatment of Parkinson’s disease. Review of 272 procedures. Acta Neurochir (Wein) 2007;149:867–76.CrossRefGoogle ScholarPubMed
7.Sillay, KA, Larson, PS, Starr, PA, et al. Deep brain stimulator hardware-related infections: incidence and management in a large series. Neurosurgery 2008;62:360–7.CrossRefGoogle Scholar
8.Temel, Y, Ackermans, L, Celik, H, et al. Management of hardware infections following deep brain stimulation. Acta Neurochir (Wein) 2004;146:355–61.Google ScholarPubMed
9.Peña, E, Pastor, J, Hernando, V, et al. Skin erosion over implants in deep brain stimulation patients. Stereotact Funct Neurosurg 2008;86:120–6.Google Scholar
10.Goodman, RR, Kim, B, McClelland, S III, et al. Operative techniques and morbidity with subthalamic nucleus deep brain stimulation in 100 consecutive patients with advanced Parkinson’s disease. J Neurol Neurosurg Psychiatry 2006;77:12–7.Google Scholar
11.Hamani, C, Lozano, AM. Hardware-related complications of deep brain stimulation: a review of the published literature. Stereotact Funct Neurosurg 2006;84:248–51.Google Scholar
12.Blomstedt, P, Jabre, M, Bejjani, B-P. Electromagnetic environmental influences on implanted deep brain stimulators. Neuromodulation 2006;9:262–9.CrossRefGoogle ScholarPubMed
13.Bejjani, BP, Damier, P, Arnulf, I, et al. Transient acute depression induced by high-frequency deep-brain stimulation. N Engl J Med 1999;340:1476–80.Google Scholar
14.Berney, A, Vingerhoets, F, Perrin, A, et al. Effect on mood of subthalamic DBS for Parkinson’s disease: a consecutive series of 24 patients. Neurology 2002;59:1427–9.Google Scholar
15.Krack, P, Batir, A, Van Blercom, N, et al. Five-year follow-up of bilateral stimulation of the subthalamic nucleus in advanced Parkinson’s disease. N Engl J Med 2003;349:1925–34.Google Scholar
16.Kulisevsky, J, Berthier, ML, Gironell, A, et al. Mania following deep brain stimulation for Parkinson’s disease. Neurology 2002;59:1421–4.CrossRefGoogle ScholarPubMed
17.Houeto, JL, Mesnage, V, Mallet, L, et al. Behavioural disorders, Parkinson’s disease and subthalamic stimulation. J Neurol Neurosurg Psychiatry 2002;72:701–7.Google Scholar
18.Morgan, JC, di Donato, CJ, Jenkins, PD, et al. Selfstimulatory behaviour associated with deep brain stimulation in Parkinson’s disease. Mov Disord 2006;21:283–5.Google Scholar
19.Sensi, M, Eleopra, R, Cavallo, MA, et al. Explosive aggressive behavior related to bilateral subthalamic stimulation. Parkinsonism Relat Disord 2004;10:247–51.Google Scholar
20. Martin, WA, Camenzind, E, Burkhard, PR. ECG artifact due to deep brain stimulation. Lancet 2003;361:1431.CrossRefGoogle ScholarPubMed
21.Constantoyannis, C, Heilbron, B, Honey, CR. Electrocardiogram artifacts caused by deep brain stimulation. Can J Neurol Sci 2004;31:343–6.CrossRefGoogle ScholarPubMed
22.Yamamoto, T, Katayama, Y, Fukaya, C, et al. Thalamotomy caused by cardioversion in a patient treated with deep brain stimulation. Stereotact Funct Neurosurg 2000;74:73–82.Google Scholar
23.Medtronic. MRI guidelines for Medtronic deep brain stimulation systems. Available at: http://professional.medtronic.com/wcm/groups/mdtcom_sg/@mdt/@neuro/documents/documents/dbs-2007-mri.pdf (accessed Jan 2011).Google Scholar
24.Weaver, J, Kim, SJ, Lee, MH, Torres, A. Cutaneous electrosurgery in a patient with a deep brain stimulator. Dermatol Surg 1999;25:415–7.Google Scholar
25.Nutt, JG, Anderson, VC, Peacock, JH, et al. DBS and diathermy interaction induces severe CNS damage. Neurology 2001;56:1384–6.CrossRefGoogle ScholarPubMed
26.Medtronic. Important diathermy safety information. Minneapolis (MN): Medtronic; 2005.Google Scholar