Status Epilepticus After Subthalamic Deep Brain Stimulation Surgery in a Patient with Parkinson's Disease.

BACKGROUND: Subthalamic deep brain stimulation (DBS) is a well-established treatment for patients with Parkinson's disease who suffer from severe motor fluctuations. The most common surgery-related complications are temporary confusion, bleedings, infections, and seizures. Seizures have been described to occur mainly around the time of the implantation of electrodes and, at present, the best established risk factors for seizures in association with DBS surgery are bleedings. A postoperative status epilepticus as complication of DBS surgery has never been described before.

CASE DESCRIPTION: We report on a patient with Parkinson's disease who developed focal seizures of the right hand and an increasing somnolence, which led to a comatose state 3 days after DBS surgery. Repeated electroencephalograms indicated a status epilepticus, which continued for 2 months until the patient regained consciousness. The patient's state improved slowly. Although basically a good effect of DBS on her parkinsonian symptoms was observed, severe neuropsychologic deficits persisted. Unfortunately, she died 8 months after surgery as a consequence of a fall with a complicated pelvic fracture.

CONCLUSIONS: This is a first report on a status epilepticus after DBS surgery, implicating that this complication has to be considered as differential diagnosis in somnolent patients after this operation.