• Neuromodulation · Oct 2014

    Review

    Differential diagnosis of psychiatric symptoms after deep brain stimulation for movement disorders.

    • Davin K Quinn, Amanda Deligtisch, Caleb Rees, Aaron Brodsky, Daniel Evans, Mohamad Khafaja, and Christopher C Abbott.
    • Department of Psychiatry, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.
    • Neuromodulation. 2014 Oct 1;17(7):629-36; discussion 636.

    ObjectivesThe presence of a deep brain stimulator (DBS) in a patient with a movement disorder who develops psychiatric symptoms poses unique diagnostic and therapeutic challenges for the treating clinician. Few sources discuss approaches to diagnosing and treating these symptoms.Materials And MethodsThe authors review the literature on psychiatric complications in DBS for movement disorders and propose a heuristic for categorizing symptoms according to their temporal relationship with the DBS implantation process.ResultsPsychiatric symptoms after DBS can be categorized as preimplantation, intra-operative/perioperative, stimulation related, device malfunction, medication related, and chronic stimulation related/long term. Once determined, the specific etiology of a symptom guides the practitioner in treatment.ConclusionsA structured approach to psychiatric symptoms in DBS patients allows practitioners to effectively diagnose and treat them when they arise.© 2014 International Neuromodulation Society.

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