Download PDF
CC BY-NC-ND 4.0 · Asian J Neurosurg 2019; 14(04): 1275-1276
DOI: 10.4103/ajns.AJNS_47_18
Case Report

Intraoperative management of a patient for deep brain stimulation with severe dyskinesia and tremors: Ketamine to the rescue!

Suman Sokhal
0   Department of Neuroanaesthesiology and Critical Care, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi
,
Keshav Goyal
0   Department of Neuroanaesthesiology and Critical Care, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi
,
Navdeep Sokhal
0   Department of Neuroanaesthesiology and Critical Care, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi
,
Niraj Kumar
0   Department of Neuroanaesthesiology and Critical Care, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi
,
Shweta Kedia
1   Department Neurosurgery, All India Institute of Medical Sciences, New Delhi
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

The loss of dopaminergic neurons from the substantia nigra pars compacta characterizes the classical pathology of Parkinson's disease (PD). Deep brain stimulation (DBS) has become an increasingly common treatment for PD. Sometimes excessive tremors due to exacerbated PD hinder the surgery and may almost make it impossible. This is a case report highlights use of IV ketamine for intraoperative sedation of a patient with PD, with severe dyskinesia & tremors, posted for DBS. IV ketamine resulted in prompt abolition of tremors and dyskinesia, which were unresponsive to previous traditional sedative drugs.

Key-words:

Deep brain stimulation - dyskinesia - ketamine - Parkinson's disease - sedation

Financial support and sponsorship

Nil.




Publication History

Article published online:
09 September 2022

© 2019. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Hallett PJ, Standaert DG. Rationale for and use of NMDA receptor antagonists in Parkinson's disease. Pharmacol Ther 2004;102:155-74.
  • 2 Nicholson G, Pereira AC, Hall GM. Parkinson's disease and anaesthesia. Br J Anaesth 2002;89:904-16.
  • 3 Starr MS, Starr BS, Kaur S. Stimulation of basal and L-DOPA-induced motor activity by glutamate antagonists in animal models of Parkinson's disease. Neurosci Biobehav Rev 1997;21:437-46.
  • 4 Lang AE, Lozano AM. Parkinson's disease. First of two parts. N Engl J Med 1998;339:1044-53.
  • 5 Sherman SJ, Estevez M, Magill AB, Falk T. Case reports showing a long-term effect of subanesthetic ketamine infusion in reducing l-DOPA-induced dyskinesias. Case Rep Neurol 2016;8:53-8.
  • 6 Gorlin AW, Rosenfeld DM, Ramakrishna H. Intravenous sub-anesthetic ketamine for perioperative analgesia. J Anaesthesiol Clin Pharmacol 2016;32:160-7.
  • 7 Iyer S, Maybhate A, Presacco A, All AH. Multi-limb acquisition of motor evoked potentials and its application in spinal cord injury. J Neurosci Methods 2010;193:210-6.