A stroke of silence: tinnitus suppression following placement of a deep brain stimulation electrode with infarction in area LC

Case report

View More View Less
  • 1 Departments of Neurological Surgery and
  • | 2 Otolaryngology–Head and Neck Surgery, University of California, San Francisco, California
Restricted access

Purchase Now

USD  $45.00

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $515.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $612.00
Print or Print + Online

The authors report on a case of tinnitus suppression following deep brain stimulation (DBS) for Parkinson disease. A perioperative focal vascular injury to area LC, a locus of the caudate at the junction of the head and body of the caudate nucleus, is believed to be the neuroanatomical correlate.

A 56-year-old woman underwent surgery for implantation of a DBS lead in the subthalamic nucleus to treat medically refractory motor symptoms. She had comorbid tinnitus localized to both ears. The lead trajectory was adjacent to area LC. Shortly after surgery, she reported tinnitus suppression in both ears. Postoperative MRI showed focal hyperintensity of area LC on T2-weighted images. At 18 months, tinnitus localized to the ipsilateral ear remained completely silenced, and tinnitus localized to the contralateral ear was substantially suppressed due to left area LC injury.

To the authors' knowledge, this is the first report of a discrete injury to area LC that resulted in bilateral tinnitus suppression. Clinicians treating patients with DBS may wish to include auditory phantom assessment as part of the neurological evaluation.

Abbreviations used in this paper:

DBS = deep brain stimulation; LC = locus of caudate; PD = Parkinson disease.

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $515.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $612.00
  • 1

    Binder DK, , Rau GM, & Starr PA: Risk factors for hemorrhage during microelectrode-guided deep brain stimulator implantation for movement disorders. Neurosurgery 56:722732, 2005

    • Search Google Scholar
    • Export Citation
  • 2

    Cheung SW, & Larson PS: Tinnitus modulation by deep brain stimulation in locus of caudate neurons (area LC). Neuroscience 169:17681778, 2010

    • Search Google Scholar
    • Export Citation
  • 3

    Larson PS, & Cheung SW: Deep brain stimulation in area LC controllably triggers auditory phantom percepts. Neurosurgery 70:398406, 2012

    • Search Google Scholar
    • Export Citation
  • 4

    Lowry LD, , Eisenman LM, & Saunders JC: An absence of tinnitus. Otol Neurotol 25:474478, 2004

  • 5

    Selemon LD, & Goldman-Rakic PS: Longitudinal topography and interdigitation of corticostriatal projections in the rhesus monkey. J Neurosci 5:776794, 1985

    • Search Google Scholar
    • Export Citation
  • 6

    Yeterian EH, & Pandya DN: Corticostriatal connections of the superior temporal region in rhesus monkeys. J Comp Neurol 399:384402, 1998

    • Search Google Scholar
    • Export Citation
  • 7

    Zrinzo L, , Foltynie T, , Limousin P, & Hariz MI: Reducing hemorrhagic complications in functional neurosurgery: a large case series and systematic literature review. Clinical article. J Neurosurg 116:8494, 2012

    • Search Google Scholar
    • Export Citation

Metrics

All Time Past Year Past 30 Days
Abstract Views 1239 380 27
Full Text Views 222 29 0
PDF Downloads 182 18 0
EPUB Downloads 0 0 0