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
Neurosurgeryjournal_title
Neurosurgeryauthors
Ackermans L,Temel Y,Bauer NJ,Visser-Vandewalle V,Dutch-Flemish Tourette Surgery Study Group.doi
10.1227/01.neu.0000303208.00242.a6subject
Has Abstractpub_date
2007-11-01 00:00:00pages
E1100; discussion E1100issue
5eissn
0148-396Xissn
1524-4040pii
00006123-200711000-00026journal_volume
61pub_type
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