Bilateral effects of unilateral thalamic deep brain stimulation: A case report

Norbert Kovacs, Endre Pal, Hajnalka Merkli, Lorant Kellenyi, Ferenc Nagy, Jozsef Janszky, Istvan Balas

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

A recent study has proved that unilateral deep brain stimulation (DBS) of the subthalamic nucleus has bilateral effects. However, it is still unclear whether unilateral ventral intermediate thalamic nucleus (Vim) DBS exerts exclusively contralateral or bilateral effects on tremor. Previous studies demonstrated a clinically irrelevant improvement on the nontarget side after thalamic stimulator implantation, which was considered to be solely the result of mechanical effects. We report here the case of a 55-year-old woman in whom unilateral thalamic DBS can stop the disabling postural-kinetic tremor in both hands. Simultaneous surface electromyography (sEMG), accelerometry, and video recordings were obtained to evaluate the underlying mechanism. After the right Vim DBS was turned off, moderate rest tremor appeared in both hands accompanied by bilateral bursts on sEMG. Because right hand tremor cannot simply reflect the mechanical overflow of the left side, the bilateral improvement caused by right Vim DBS is probably due to an active tremor reduction in this particular case.

Original languageEnglish
Pages (from-to)276-279
Number of pages4
JournalMovement Disorders
Volume23
Issue number2
DOIs
Publication statusPublished - Jan 30 2008

Keywords

  • Deep brain stimulation
  • Mitochondrial encephalopathy, thalamotomy, tremor, ventral intermediate nucleus

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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