Tremor and Other Hyperkinetic Movements

High Voltage VIM Region Deep Brain Stimulation Mimicking Progressive Supranuclear Palsy

Addie Patterson, Michael Okun, Christopher Hess


Background: Deep brain stimulation (DBS) for essential tremor (ET) can cause unwanted side effects.

Case Report: A patient with ET underwent unilateral dual-lead thalamic DBS. He later developed parkinsonism with atypical features and was diagnosed with progressive supranuclear palsy. During presentation for a second opinion, stimulation-induced side effects were suspected. Inactivation of DBS resolved atypical features and superimposed idiopathic Parkinson Disease (PD) was diagnosed.

Discussion: This case illustrates the importance of recognizing the possible influence of stimulation-induced side effects and discusses when to utilize dual-lead DBS for ET and the co-occurrence of ET and PD.


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