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Two cases of ischemia associated with subthalamic nucleus stimulator implantation for advanced Parkinson's disease

✍ Scribed by Kevin E. Novak; Emmanuel K. Nenonene; Lawrence P. Bernstein; Sandra Vergenz; Gina Medalle; Jordan M. Prager; Theodore W. Eller; Jeffrey W. Cozzens; Michael Rezak

Publisher
John Wiley and Sons
Year
2006
Tongue
English
Weight
192 KB
Volume
21
Category
Article
ISSN
0885-3185

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✦ Synopsis

Abstract

Deep brain stimulation is generally a safe and effective method of alleviating motor impairment in advanced‐stage Parkinson's disease patients. However, adverse events of surgery have been noted, such as hemorrhage, infection, seizures, and device failure. In this report, we describe 2 cases of the unusual adverse event of ischemia associated with subthalamic nucleus stimulator implantation. We present the intraoperative neurological symptoms, microelectrode recording data, imaging findings, and other correlated events. In the first case, the clinical effects of ischemia were evident intraoperatively and coincided with silence during microelectrode recording from the ischemic region. In the second case, the timing of the ischemic event could not be determined precisely but also was associated with a difficult mapping. Subcortical ischemia may be an underrecognized event that confounds neurophysiological mapping of deep brain structures and affects clinical outcomes. Β© 2006 Movement Disorder Society

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