Objectives The presence of a deep brain stimulator (DBS) in a patient who develops neuropsychiatric symptoms poses unique diagnostic challenges and questions for the treating psychiatrist. Catatonia has been described only once, during DBS implantation, but has not been reported in a successfully implanted DBS patient. Materials/Methods We present a case of a patient with bipolar disorder and renal transplant who developed catatonia after DBS for essential tremor. Results The patient was successfully treated for catatonia with lorazepam and electroconvulsive therapy (ECT) after careful diagnostic workup. ECT has been successfully used with DBS in a handful of cases and certain precautions may help reduce potential risk. Conclusions Catatonia is a rare occurrence after DBS, but when present may be safely treated with standard therapies such as lorazepam and ECT.

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ECT was successfully administered to a depressed woman who had had a craniotomy and had postoperative seizures. For ECT after craniotomy, the authors recommend postneurosurgical stabilization, continuation of anticonvulsants if a seizure disorder is present, and proper electrode placement.

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