Accessory nerve injury after deep brain stimulation surgery in a Parkinson’s disease patient

Abstract

DBS is an established form of surgical therapy for Parkinson's disease and is also used for other pathologies, such as dystonia and essential tremor. There are few articles in the literature discussing exclusively about surgical complications. In fact, most papers describe surgical-related complications such seizures, device infection, hemorrhage and permanent deficit. However, less usual complications can also occur, as in the case described below, of an injury to the accessory nerve after the DBS procedure.We describe a case of a 56-year-old woman with PD who underwent to STN DBS, presented hypotrophy and weakness of the right trapezius after the surgery. Electroneuromyography (ENMG) suggested partial right spinal accessory injury. Patient recovery spontaneously 5 months after surgery. While DBS promises dramatic improvement in select PD symptoms, it can have disappointing or even serious adverse results. This paper ratifies the need of screening of accessory nerve injury for early rehabilitation.

Keywords

• Deep brain stimulation
• Complications
• Parkinson’s disease
• Spinal accessory nerve
• Case report