Objective: In order to know what degree of psychiatric complication is hazard to deep brain stimulation (DBS) in patients with Parkinson’s disease, we report and analyse pre-, peri-, and post-operative state of a DBS case who were suffered from psychiatric problems.

Background: In general, psychiatric complication such as delirium, hallucination, and delusion is relative contraindicative factor in DBS operation because of peri-operative psychiatric complications. Although in Parkinsonian patients with psychiatric complication, it is difficult to improve motor fluctuation only with medications. We often fall in to “no-win situation”. More medication leads more psychiatric complication, less medication leads more severe off-state in advanced stage Parkinson’s disease.

Methods: A 58 year-old female whose disease duration of Parkinson’s disease is12 years visited our hospital. She had suffered from mareked wearing-off and peak-dose dyskinesia. Her behavior is not deteriorated, however she had tendency to have compulsive idea. Adjustment of medication was not succeded to improve motor fluctuation. After she was advmitted to be evaluated the indication of DBS, she had started to have hallucination and delusion.

Results: Her delusion was exacerbated in few days and finally she felt a daughter of her was arrested and binded beneath her bed. She called a police from her hospital room. The change of the circumstances is thougt to be a trigger of this psychiatric complication, therefore she was dischareged to go back home. However her delusion was not improved at all after her discharge. Neuroleptics was administrated and dopaminergic medications were decreased or stopped. With lisperidon, her delusion was improved, on the other hand, motor symptoms was worsed and she needed help in ADL. Administration of lisperidon made her psychiatric complication was decreased and dispapearied. After 6 month continuous free of psychiatric symptoms, DBS operation was performed. In the peri-operative period, symptoms were not exac. In the post-operative period, no delusion was induced even after 6 months after start stimulation.

Conclusions: We suspect that DBS operation under adequate control of psychiatric symptoms is safe even if patients have psychiatric problems.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/deep-brain-stimulation-in-a-parkinsonian-patient-with-sever-psychiatric-complication/