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Two cases of ischemia associated with subthalamic nucleus stimulator implantation for advanced Parkinson's disease
Author(s) -
Novak Kevin E.,
Nene Emmanuel K.,
Bernstein Lawrence P.,
Vergenz Sandra,
Medalle Gina,
Prager Jordan M.,
Eller Theodore W.,
Cozzens Jeffrey W.,
Rezak Michael
Publication year - 2006
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.20947
Subject(s) - parkinson's disease , subthalamic nucleus , medicine , ischemia , central nervous system disease , neuroscience , disease , degenerative disease , deep brain stimulation , physical medicine and rehabilitation , cardiology , psychology
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. © 2006 Movement Disorder Society