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DBS treatment efficacy in a patient with Cerebellar lesion
Frank Boutsen, Marc Lenaerts, and Angela Rexwinkle

This case study details the course of symptoms and treatment history of a patient who following a stroke to the left cerebellum presented with a severe debilitating tremor affecting his speech and his left upper extremity. Remarkably, he presented with a myoclonus that affected the palate, voice, his left face and his left arm. Three years after the stroke, the patient received a deep brain stimulator with a right thalamic lead. After stimulation parameter adjustment, the patient improved significantly. The tremor was decreased and the patient regained some ability to do various hand tasks including writing. Improvement was maintained for about two weeks but then declined. Recently, the patients’ cognitive motor abilities were tested when the voltage settings of his stimulator were varied (baseline, up 10%, down 10% and off). Results revealed no significant variations in his speech, hand, and eye movement with parameter adjustment. Overall, however, by patient report and subjective exam the tremor appeared mildly improved compared to pre-surgical status. In addition, eye tracking data revealed that regardless of the stimulator setting the patient was able to identify letters correctly using eyemovement responses when he could not nearly do this to the same degrees for shapes when the requirements in the stroop like task were kept identical.

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