Following deep brain stimulation (DBS) surgery, a variety of potential mechanical or functional complications ranging from perioperative events to hardware malfunction may occur. We present 2 patients who developed a unique complication of cyst formation at the tip of the DBS electrode in the absence of infection. One patient had a unilateral ventral intermediate lead placement for essential tremor, and the other had bilateral subthalamic nucleus (STN) placement for Parkinson's disease. After a period of symptom control, at 3 and 8 months after surgery, respectively, both patients developed new neurological deficits and were found to have a cyst at the left DBS lead tip. The right lead in the patient with the bilateral STN implant was without issue. Both affected leads were removed and the problematic symptoms regressed quickly over several days, though the lesion effect on the patients' initial tremor symptoms lasted for months. Bacteriological cultures of the removed electrodes and wounds were negative. We report a rare complication of DBS and show that simply removing the involved lead results in cyst resolution.

Parkinson's disease (PD) is a common, debilitating neurodegenerative disorder that creates a significant burden for patients, family members and society at large. Major unmet needs include effective therapies that could favorably modify the underlying pathogenetic processes in PD, and better control of motor and nonmotor symptoms in advanced-stage disease. This review examines the current state of development of potential PD therapies, including dopaminergic therapies, modulators of adenosine and glutamate receptors, cell-based therapies, genetic therapies and device-based therapies. In addition, research into potential neuroprotective agents and pipeline therapies for nonmotor symptoms of PD are summarized.

Gilles de la Tourette’s syndrome (GTS) is a neuropsychiatric disorder that often presents with a complex array of motor and phonic tics that persist over the majority of a person’s life. GTS often presents with comorbidities such as attention-deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), and mood disorders. Psychosocial sequelae are also common among this population. We present the case of a 49-year-old woman with severe, lifelong GTS complicated by OCD, inattention, impulsivity, disinhibition, mood disturbances, generalized anxiety, and pain secondary to motor tics. Habit reversal therapy (HRT) is used with full body relaxation conditioned as a competitive response to target her tics, anxiety, and pain simultaneously. The patient demonstrates significant reduction of symptoms and improvement in psychosocial status within four sessions. She is able to maintain this status at a 3-month follow-up session. Aspects of case conceptualization and therapeutic technique are discussed.

Gilles de la Tourette's syndrome (GTS) is a neuropsychiatric disorder that often presents with a complex array of motor and phonic tics that persist over the majority of a person's life. GTS often presents with comorbidities such as attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), and mood disorders. Psychosocial sequelae are also common among this population. We present the case of a 49-year-old female with severe, lifelong GTS complicated by OCD, inattention, impulsivity, disinhibition, mood disturbances, generalized anxiety, and pain secondary to motor tics. Habit reversal therapy (HRT) was used with full body relaxation conditioned as a competitive response to target her tics, anxiety, and pain simultaneously. The patient demonstrated significant reduction of symptoms and improvement in psychosocial status within four sessions. She was able to maintain this status at a 3 month follow-up session. Aspects of case conceptualization and therapeutic technique are discussed.