High-voltage VIM Region Deep Brain Stimulation Mimicking Progressive Supranuclear Palsy

BACKGROUND Deep brain stimulation (DBS) for essential tremor (ET) can cause unwanted side effects. CASE REPORT A patient with ET underwent unilateral dual-lead thalamic DBS. He later developed parkinsonism with atypical features and was diagnosed with progressive supranuclear palsy. During presentation for a second opinion, stimulation-induced side effects were suspected. Inactivation of DBS resolved atypical features and superimposed idiopathic Parkinson disease (PD) was diagnosed. DISCUSSION This case illustrates the importance of recognizing the possible influence of stimulation-induced side effects and discusses when to utilize dual-lead DBS for ET and the co-occurrence of ET and PD.