DBS reduced hemichorea associated with a developmental venous anomaly and microbleeding in STN

Tao Xie; Issam Awad; Un Jung Kang; Peter Warnke

doi:10.1212/WNL.0000000000000124

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Developmental venous anomaly (DVA) is the most common vascular malformation and is usually asymptomatic. Movement disorders associated with DVA have rarely been reported, except a case of hemichorea and hemiballism caused by DVA in the contralateral putamen associated with hyperglycemia.¹ The abnormal movements in that case nearly resolved after treatment with insulin and risperidone. We report a case of DVA who presented with hemichorea without metabolic derangement but microbleeding surrounding the DVA in the contralateral subthalamic nucleus (STN) area. The lesion was unresectable and deep brain stimulation (DBS) of globus pallidus interna (GPi) helped control the pharmacologically refractory symptoms.

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Author contributions: Tao Xie: drafting and revising the manuscript for content and analysis of data, intraoperative monitoring, DBS programming. Issam Awad: revising the manuscript for content and analysis of data. Un Jung Kang: revising the manuscript for content and analysis of data. Peter Warnke: revising the manuscript for content and analysis of data, performing the surgery.
Study funding: No targeted funding reported.
Disclosure: T. Xie and I. Awad report no disclosures. U. Kang is on the medical advisory board of CVS/Caremark. P. Warnke reports being Associate Editor of the Journal of Neurology, Neurosurgery and Psychiatry. Go to Neurology.org for full disclosures.

Received June 26, 2013.
Accepted in final form October 14, 2013.

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