Background: Deep brain stimulation (DBS) has been shown to be effective for parkinsonian symptoms poorly\nresponsive to medications. DBS is typically well-tolerated, as are the maintenance battery changes. Here we\ndescribe an adverse event during a battery replacement procedure that caused rapid onset of severe depression.\nCase Presentation: The patient is a 58-year-old woman who was in a serious motor vehicle accident and sustained a\nconcussion with loss of consciousness. Within weeks of the accident she began developing parkinsonian symptoms that\nprogressively worsened over the subsequent 10 years. Responding poorly to medications, she received DBS,\nwhich controlled her movement symptoms. Five years after initiating DBS, during a routine battery change, an apparent\nelectrical event occurred that triggered the rapid onset of severe depression. Anti-seizure and antidepressant medications\nwere ineffective, and the patient was offered a course of electroconvulsive therapy (ECT), which resulted in complete\nreversal of her depressive episode.\nConclusion: Parkinson�s syndrome can be seen after a single closed head injury event. Post-traumatic parkinsonism is\nresponsive to DBS; however, DBS has been associated with an infrequent occurrence of dramatic disruption in mood. ECT\nis a therapeutic option for patients who develop intractable depressive illness associated with DBS.
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