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From the Movement Disorders Unit, Department of Neurology (Drs. Kulisevsky, Gironell, and Pascual-Sedano) and Neurosurgery (Drs. Molet and Parés), Functional Neurosurgery Program for Movement Disorders, Sant Pau Hospital, Autonomous University of Barcelona; and University of Malaga (Dr. Berthier), Spain.
Address correspondence and reprint requests to Dr. J. Kulisevsky, Movement Disorders Unit, Department of Neurology, Hospital de Sant Pau, Av.Sant Antoni Ma Claret 167, 08025 Barcelona, Spain; e-mail: jkulisevsky{at}hsp.santpau.es
Three patients with PD developed manic behavior after bilateral implantation of electrodes for deep-brain stimulation (DBS). Common to all three patients were manic symptoms unremitting after levodopa reduction or stimulation "off," lower electrodes positioning caudal to the subthalamic nucleus area, postoperative DBS with the lower contacts (0) of the quadripolar electrodes, and resolution of the manic episodes coinciding with stimulation through higher contacts.
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