Neurosurg Focus
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Case Reports
Deep brain stimulation for the obsessive-compulsive and Tourette-like symptoms of Kleefstra syndrome.
Deep brain stimulation (DBS) has been reported to have beneficial effects in severe, treatment-refractory cases of obsessive-compulsive disorder (OCD) and Tourette syndrome (TS). In this report, the authors present the first case in which DBS was used to treat the neuropsychiatric symptoms of Kleefstra syndrome, a rare genetic disorder characterized by childhood hypotonia, intellectual disability, distinctive facial features, and myriad psychiatric and behavioral disturbances. ⋯ Symptoms recurred when both DBS electrodes failed because of lead fracture and dislodgement, although the clinical benefits were restored by lead replacement. The symptomatic and functional improvements observed in this case of VC/VS DBS for Kleefstra syndrome suggest a novel indication for DBS worthy of further investigation.
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Cases of postoperative psychosis in Parkinson's disease patients receiving deep brain stimulation (DBS) treatment have previously been published. However, the magnitude of symptom incidence and the clinical risk factors are currently unknown. This retrospective study sheds light on these issues by investigating psychosis in a group of 128 Parkinson's disease patients who received DBS implants. ⋯ Although symptoms of psychosis are widely seen in patients with Parkinson's disease in the years following stimulator placement, results of the present suggest that most psychoses occurring postoperatively are likely independent of implantation and stimulation settings.
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With limited data available on association of risk factors and effect of hospital case volume on outcomes following deep brain stimulation (DBS), the authors attempted to identify these associations using a large population-based database. ⋯ The authors' study provides individualized estimates of the risks of postoperative complications based on patient demographics and comorbidities and hospital characteristics, which could potentially be used as an adjunct for risk stratification for patients undergoing DBS.