Post-traumatic hyperkinesias in patients with Parkinson's disease with stimulation of the subthalamic nucleus

Deep brain stimulation (DBS) is today an established treatment option for advanced Parkinson's disease (PD). Perioperative complications and side effects such as infections, hardware problems, electrode dislocation and misplaced or fractured leads have been reported in numerous publications. Here, we describe a new clinical entity of pathological transient hyperkinesias after trauma in PD patients treated with DBS in the subthalamic nucleus (STN) without any signs of hardware damage. The hyperkinesias lasted several hours and were selflimiting. Possible pathophysiological mechanisms causing hyperkinesias are discussed, and a procedure for clinical management of trauma-related pathological transient hyperkinesias is suggested.