Pregnancy and Delivery in a Generalized Dystonia Patient Treated with Internal Globus Pallidal Deep Brain Stimulation: a Case Report.
10.3346/jkms.2017.32.1.155
- Author:
Hye Ran PARK
1
;
Jae Meen LEE
;
Hyeyoung PARK
;
Chae Won SHIN
;
Han Joon KIM
;
Hee Pyoung PARK
;
Dong Gyu KIM
;
Beom Seok JEON
;
Sun Ha PAEK
Author Information
1. Department of Neurosurgery, Soonchunhyang University Seoul Hospital, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Deep Brain Stimulation;
Dystonia;
Globus Pallidus;
Child Birth and Care
- MeSH:
Adult;
Anesthesia;
Anesthesia, General;
Child;
Deep Brain Stimulation*;
Dystonia*;
Electrocoagulation;
Female;
Globus Pallidus;
Hand;
Hemostasis;
Housekeeping;
Humans;
Intubation;
Parturition;
Pregnancy*;
Succinylcholine;
Thiopental;
Upper Extremity
- From:Journal of Korean Medical Science
2017;32(1):155-159
- CountryRepublic of Korea
- Language:English
-
Abstract:
Internal globus pallidus (GPi) deep brain stimulation (DBS) has been widely accepted as an effective treatment modality of medically refractory dystonia. However, there have been few studies regarding the safety issue of pregnancy and childbirth related with DBS. This report describes a female patient who was pregnant and delivered a baby after GPi DBS surgery. A 33-year-old female patient with acquired generalized dystonia underwent bilateral GPi DBS implantation. She obtained considerable improvement in both movement and disability after DBS implantation. Four years later, she was pregnant and the obstetricians consulted us about the safety of the delivery. At 38-weeks into pregnancy, a scheduled caesarian section was carried out under general anesthesia. After induction using thiopental and succinylcholine, intubation was done quickly, followed by DBS turn off. For hemostasis, only bipolar electrocautery was used. Before awakening from the anesthesia, DBS was turned on as the same parameters previously adjusted. After delivery, she could feed her baby by herself, because the dystonia of left upper extremity and hand was improved. Until now, she has been showing continual improvement and being good at housework, carrying for children, with no trouble in daily life. This observation indicates that the patients who underwent DBS could safely be pregnant and deliver a baby.
