Pallidal deep brain stimulation and intraoperative neurophysiology for treatment of poststroke hemiballism

Abstract

Deep brain stimulation is a recognized and effective treatment for several movement disorders. Nevertheless, the efficacy of this intervention on abnormal movements secondary to structural brain pathologies is less consistent. In this report, we describe a case of hemiballism–hemichorea due to a peripartum ischemic stroke‐treated with deep brain stimulation of the globus pallidus internus. Patient observed marked improvement in her symptoms at long‐term follow‐up. Neurophysiologic data revealed lower globus pallidus internus firing rates compared to other hyperkinetic disorders. Pallidal deep brain stimulation is a plausible option for medically refractory hemiballism–hemichorea and cumulative data from multiple centers may be used to fully evaluate its efficacy.

Deep Brain Stimulation for the Treatment of Hemichorea: Case Series and Literature Review

“…We performed a PubMed search (key words included were "hemichorea DBS," "hemiballismus DBS," "pallidal deep brain stimulation," "hemichorea-hemiballismus," "treatment of hemiballismus," and "treatments for hemichorea") and found eight other published cases of HC-HB treated with DBS (Table 1) [8][9][10][11][12][13][14][15]. The majority of cases were due to stroke, with other cases resulting from trauma, hyperglycemia, vascular malformation.…”

Post-stroke Hemichorea Responding to Repetitive Transcranial Magnetic Stimulation Using a Parabolic Coil: A Case Report

“…Patients with severe symptoms cannot accomplish the activities of daily living, and they also have poor functional outcomes. Strategies for hemichorea include pharmacological and surgical therapy [2]. Low doses of neuroleptics are often welltolerated, but with unsatisfactory e cacy; in contrast, high doses are rarely helpful because of unacceptable side effects.…”