Successful long-term deep brain stimulation for hemichorea-hemiballism in a patient with diabetes. Case report

J Neurosurg. 2005 Jun;102(6):1137-41. doi: 10.3171/jns.2005.102.6.1137.

Abstract

The authors report a case of hemichorea-hemiballism (HC-HB) that was successfully treated using deep brain stimulation (DBS). A 65-year-old right-handed man exhibited a sudden onset of right HC-HB without a diabetic coma. At admission T1-weighted magnetic resonance (MR) images revealed a high-intensity signal in the left striatum, contralateral to the patient's involuntary movements. The HC-HB continued for 5 months after onset of the condition despite medical treatment and a decreased intensity of the signal on T1-weighted MR images. The patient underwent placement of a quadripolar DBS electrode in the left thalamus, including the left ventral oralis (VO) anterior and posterior nuclei (the VO complex). Postoperatively, the right-sided HC-HB disappeared rapidly during electrical stimulation and there were no neurological deficits. The authors demonstrate that DBS can be an effective treatment for medically refractory HC-HB. This is the first case of HC-HB that has been successfully treated with DBS.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Chorea / complications
  • Chorea / diagnostic imaging
  • Chorea / therapy*
  • Deep Brain Stimulation*
  • Diabetes Mellitus, Type 1 / complications*
  • Dyskinesias / complications
  • Dyskinesias / diagnostic imaging
  • Dyskinesias / therapy*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Tomography, X-Ray Computed