Intraoperative Management of a Patient for Deep Brain Stimulation with Severe Dyskinesia and Tremors: Ketamine to the Rescue!

Suman Sokhal; Keshav Goyal; Navdeep Sokhal; Niraj Kumar; Shweta Kedia

doi:10.4103/ajns.AJNS_47_18

Intraoperative Management of a Patient for Deep Brain Stimulation with Severe Dyskinesia and Tremors: Ketamine to the Rescue!

Asian J Neurosurg. 2019 Nov 25;14(4):1275-1276. doi: 10.4103/ajns.AJNS_47_18. eCollection 2019 Oct-Dec.

Authors

Suman Sokhal¹, Keshav Goyal¹, Navdeep Sokhal¹, Niraj Kumar¹, Shweta Kedia²

Affiliations

¹ Department of Neuroanaesthesiology and Critical Care, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, India.
² Department Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.

Abstract

The loss of dopaminergic neurons from the substantia nigra pars compacta characterizes the classical pathology of Parkinson's disease (PD). Deep brain stimulation (DBS) has become an increasingly common treatment for PD. Sometimes excessive tremors due to exacerbated PD hinder the surgery and may almost make it impossible. This is a case report highlights use of IV ketamine for intraoperative sedation of a patient with PD, with severe dyskinesia & tremors, posted for DBS. IV ketamine resulted in prompt abolition of tremors and dyskinesia, which were unresponsive to previous traditional sedative drugs.

Keywords: Deep brain stimulation; Parkinson's disease; dyskinesia; ketamine; sedation.

Publication types

Case Reports