Propofol Reduces Microelectrode-Recording Artefacts caused by Parkinsonian Tremor during Deep Brain Stimulation

Abstract

A 51-year-old male with medically refractory Parkinson's disease was scheduled for bilateral deep brain stimulation (DBS). During microelectrode recordings (MERs) of right side DBS, the patient developed severe sustained whole-body tremors causing severe artefacts in MER. The right side DBS electrode was inserted with suboptimal MER. For the creation of left burr hole, propofol infusion at a rate of 20 μg/kg/min, was used and soon after, all tremor activity ceased. Propofol infusion was continued during left side MER. With the absence of tremors, left subthalamic nucleus spike activity was better identified and neurological testing could take place. At 6 months after DBS, the patient’s symptoms had improved significantly without the need for levodopa.