✓The authors present a unique case of hyperhidrosis as a side effect of a misplaced deep brain stimulation (DBS) electrode near the ventrointermedius (Vim) nucleus in a patient with essential tremor. Magnetic resonance imaging of the brain showed electrode placement in the left anterior thalamus traversing the hypothalamus. High-frequency electrical stimulation possibly resulted in unilateral activation of the efferent sympathetic pathways in the zona incerta. Although a rare complication, hypothalamic dysfunction may occur as a stimulation-related side effect of Vim-DBS.
Abbreviations used in this paper:DBS = deep brain stimulation; ET = essential tremor; PD = Parkinson disease; Vim = ventrointermedius; ZI = zona incerta.
Address correspondence to: Joseph Jankovic, M.D., Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, 6550 Fannin Street, Suite 1801, Houston, Texas 77030. email: