Anterior thalamic deep brain stimulation in epilepsy and persistent psychiatric side effects following discontinuation

We report a case of a patient with drug-resistant epilepsy treated with deep brain stimulation of the anterior nucleus of the thalamus (ANT-DBS). The patient developed psychiatric side effects (PSEs), namely irritability, hostility, aggressiveness, and paranoia, after implantation and stimulation in...

Full description

Bibliographic Details
Main Authors: Irena Doležalová, Jonáš Kunst, Martin Kojan, Jan Chrastina, Marek Baláž, Milan Brázdil
Format: Article
Language:English
Published: Elsevier 2019-01-01
Series:Epilepsy & Behavior Reports
Online Access:http://www.sciencedirect.com/science/article/pii/S2589986419301297
id doaj-d164007a6bc04b0a98894162b17f5c4f
record_format Article
spelling doaj-d164007a6bc04b0a98894162b17f5c4f2020-11-25T02:41:53ZengElsevierEpilepsy & Behavior Reports2589-98642019-01-0112Anterior thalamic deep brain stimulation in epilepsy and persistent psychiatric side effects following discontinuationIrena Doležalová0Jonáš Kunst1Martin Kojan2Jan Chrastina3Marek Baláž4Milan Brázdil5First Department of Neurology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic; Corresponding author at: First Department of Neurology, St. Anne's University Hospital, Pekařská 53, 656 91 Brno, Czech Republic.Faculty of Medicine, Masaryk University Brno, Czech RepublicFirst Department of Neurology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic; Central European Institute of Technology (CEITEC), Brno, Czech RepublicDepartment of Neurosurgery, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech RepublicFirst Department of Neurology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech RepublicFirst Department of Neurology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic; Department of Neurosurgery, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech RepublicWe report a case of a patient with drug-resistant epilepsy treated with deep brain stimulation of the anterior nucleus of the thalamus (ANT-DBS). The patient developed psychiatric side effects (PSEs), namely irritability, hostility, aggressiveness, and paranoia, after implantation and stimulation initiation. The stimulation was discontinued and the PSEs were mitigated, but the patient did not return to her pre-implantation state, as documented by repeated psychiatric reports and hospitalizations. To our knowledge, this is the first report of a patient who developed long-term PSEs that did not disappear after stimulation discontinuation. We suppose that ANT-DBS caused a persistent perturbation of the thalamic neuronal networks that are responsible for long-term PSEs. Keywords: Deep brain stimulation of the anterior nucleus of the thalamus, Long-term psychiatric side effects, Case reporthttp://www.sciencedirect.com/science/article/pii/S2589986419301297
collection DOAJ
language English
format Article
sources DOAJ
author Irena Doležalová
Jonáš Kunst
Martin Kojan
Jan Chrastina
Marek Baláž
Milan Brázdil
spellingShingle Irena Doležalová
Jonáš Kunst
Martin Kojan
Jan Chrastina
Marek Baláž
Milan Brázdil
Anterior thalamic deep brain stimulation in epilepsy and persistent psychiatric side effects following discontinuation
Epilepsy & Behavior Reports
author_facet Irena Doležalová
Jonáš Kunst
Martin Kojan
Jan Chrastina
Marek Baláž
Milan Brázdil
author_sort Irena Doležalová
title Anterior thalamic deep brain stimulation in epilepsy and persistent psychiatric side effects following discontinuation
title_short Anterior thalamic deep brain stimulation in epilepsy and persistent psychiatric side effects following discontinuation
title_full Anterior thalamic deep brain stimulation in epilepsy and persistent psychiatric side effects following discontinuation
title_fullStr Anterior thalamic deep brain stimulation in epilepsy and persistent psychiatric side effects following discontinuation
title_full_unstemmed Anterior thalamic deep brain stimulation in epilepsy and persistent psychiatric side effects following discontinuation
title_sort anterior thalamic deep brain stimulation in epilepsy and persistent psychiatric side effects following discontinuation
publisher Elsevier
series Epilepsy & Behavior Reports
issn 2589-9864
publishDate 2019-01-01
description We report a case of a patient with drug-resistant epilepsy treated with deep brain stimulation of the anterior nucleus of the thalamus (ANT-DBS). The patient developed psychiatric side effects (PSEs), namely irritability, hostility, aggressiveness, and paranoia, after implantation and stimulation initiation. The stimulation was discontinued and the PSEs were mitigated, but the patient did not return to her pre-implantation state, as documented by repeated psychiatric reports and hospitalizations. To our knowledge, this is the first report of a patient who developed long-term PSEs that did not disappear after stimulation discontinuation. We suppose that ANT-DBS caused a persistent perturbation of the thalamic neuronal networks that are responsible for long-term PSEs. Keywords: Deep brain stimulation of the anterior nucleus of the thalamus, Long-term psychiatric side effects, Case report
url http://www.sciencedirect.com/science/article/pii/S2589986419301297
work_keys_str_mv AT irenadolezalova anteriorthalamicdeepbrainstimulationinepilepsyandpersistentpsychiatricsideeffectsfollowingdiscontinuation
AT jonaskunst anteriorthalamicdeepbrainstimulationinepilepsyandpersistentpsychiatricsideeffectsfollowingdiscontinuation
AT martinkojan anteriorthalamicdeepbrainstimulationinepilepsyandpersistentpsychiatricsideeffectsfollowingdiscontinuation
AT janchrastina anteriorthalamicdeepbrainstimulationinepilepsyandpersistentpsychiatricsideeffectsfollowingdiscontinuation
AT marekbalaz anteriorthalamicdeepbrainstimulationinepilepsyandpersistentpsychiatricsideeffectsfollowingdiscontinuation
AT milanbrazdil anteriorthalamicdeepbrainstimulationinepilepsyandpersistentpsychiatricsideeffectsfollowingdiscontinuation
_version_ 1724776685408092160