Propofol Reduces Microelectrode-Recording Artefacts caused by Parkinsonian Tremor during Deep Brain Stimulation

Jason Chui; Rizq Alamri; Frank Bihari; Matthew Hebb; Lakshmikumar Venkatraghavan

doi:10.1055/s-0037-1618321

Journal of Neuroanaesthesiology and Critical Care, Table of Contents

CC-BY-NC-ND 4.0 · J Neuroanaesth Crit Care 2018; 05(01): 21-25
DOI: 10.1055/s-0037-1618321

Case Report

Thieme Medical and Scientific Publishers Private Limited

Propofol Reduces Microelectrode-Recording Artefacts caused by Parkinsonian Tremor during Deep Brain Stimulation

Jason Chui

¹Department of Anesthesia and Perioperative Medicine, Schulich School of Medicine and Dentistry, Western University, Ontario, Canada

,

Rizq Alamri

¹Department of Anesthesia and Perioperative Medicine, Schulich School of Medicine and Dentistry, Western University, Ontario, Canada

,

Frank Bihari

²Department of Neurophysiology, University of Western Ontario, Ontario, Canada

,

Matthew Hebb

³Department of Clinical Neurological Sciences, University of Western Ontario, Ontario, Canada

,

Lakshmikumar Venkatraghavan

⁴Department of Anesthesia, University of Toronto, Toronto Western Hospital, Toronto, Ontario, Canada

› Author Affiliations

Abstract

A 51-year-old male with medically refractory Parkinson's disease was scheduled for bilateral deep brain stimulation (DBS). During microelectrode recordings (MERs) of right side DBS, the patient developed severe sustained whole-body tremors causing severe artefacts in MER. The right side DBS electrode was inserted with suboptimal MER. For the creation of left burr hole, propofol infusion at a rate of 20 μg/kg/min, was used and soon after, all tremor activity ceased. Propofol infusion was continued during left side MER. With the absence of tremors, left subthalamic nucleus spike activity was better identified and neurological testing could take place. At 6 months after DBS, the patient’s symptoms had improved significantly without the need for levodopa.

Keywords

a tremor effect - deep brain stimulation - Parkinson’s disease - propofol

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References

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