Rescue GPi-DBS for a Stroke Associated Hemiballism in a Patient with STN-DBS

  • Genko Oyama
  • Nicholas Maling
  • Amanda Avila‐Thompson
  • Pam R. Zeilman
  • Kelly D. Foote
  • Irene A. Malaty
  • Ramon L. Rodriguez
  • Michael S. Okun


Background: Hemiballism/hemichorea commonly occurs as a result of a lesion in the subthalamic region.

Case Report: A 38‐year‐old male with Parkinson’s disease developed intractable hemiballism in his left extremities due to a small lesion that was located adjacent to the right deep brain stimulation (DBS) lead, 10 months after bilateral subthalamic nucleus (STN)‐DBS placement. He underwent a right globus pallidus internus (GPi)‐DBS lead implantation. GPi‐DBS satisfactorily addressed his hemiballism.

Discussion: This case offered a unique look at basal ganglia physiology in human hemiballism. GPi‐DBS is a reasonable therapeutic option for the treatment of medication refractory hemiballism in the setting of Parkinson’s disease.