Globus Pallidus Internus Deep Brain Stimulation for Disabling Diabetic Hemiballism/Hemichorea

Figure 2

Image-guided deep brain stimulation (DBS) of the globus pallidus internus (GPi) for refractory diabetic HH.

(a) An image in the planning software showing target localization and trajectory planning for right GPi DBS. The target was directed to the posterolateral portion of the GPi which was easily identified owing to hyperintensity in the volumetric T1-weighted MRI images

(b) An image captured from the planning software after fusion of an intraoperative O-arm CT scan with preoperative volumetric T1 images to verify the location of the implanted lead, which was taken with the patient under general anesthesia. Although the electrode was found to be about 1 mm posterior and medial to the initial target point, it was accepted

(c) An image captured from the planning software after fusion of the postoperative CT scan with preoperative volumetric T1 images. This image corresponds to the center of the 2nd contact (number 2), which was used as an anode for chronic stimulation