Vertical gaze palsy after thalamic stimulation for Tourette syndrome: case report.

Abstract:

OBJECTIVE:We describe a patient who developed a vertical gaze paralysis after deep brain stimulation performed for intractable Tourette syndrome due to a small deep bleeding in the upper mesencephalon. CLINICAL PRESENTATION:A 39-year-old man underwent thalamic deep brain stimulation for intractable Tourette syndrome. Immediately postoperatively, he had diplopia and dizziness. The neurological examination revealed vertical gaze palsy with preserved vertical oculocephalic movements. A postoperative computed tomography scan revealed a discrete high-density lesion across the midline at the distal end of the left electrode. This area corresponds with the pretectal area, including the rostral interstitial nucleus of the medial longitudinal fasciculus, with sparing of the oculomotor and rubral nuclei. INTERVENTION:Six months postoperatively, maximal upward and downward smooth pursuit eye movements were achieved. Upward saccadic velocities were still reduced by 20 to 25 degrees. CONCLUSION:This case report describes a complication that might demand special attention during the planning of thalamic deep brain stimulation for the treatment of Tourette syndrome. Examination of both horizontal and vertical eye movements during deep brain stimulation surgery is recommended.

journal_name

Neurosurgery

journal_title

Neurosurgery

authors

Ackermans L,Temel Y,Bauer NJ,Visser-Vandewalle V,Dutch-Flemish Tourette Surgery Study Group.

doi

10.1227/01.neu.0000303208.00242.a6

subject

Has Abstract

pub_date

2007-11-01 00:00:00

pages

E1100; discussion E1100

issue

5

eissn

0148-396X

issn

1524-4040

pii

00006123-200711000-00026

journal_volume

61

pub_type

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