Table 1.

Patient characteristics and DBS treatment response

	Age at onset	Symptoms	Age at DBS implant	DBS target	Stimulation response	Duration of response
Hebb et al. [6], 2006	15 months	- Complex hyperkinetic syndrome	17 years	VIM (unilateral)	- Contralateral chorea, myoclonus improved in few days to weeks	- Improvements stabilized after first year
		- Severe chorea
		- Myoclonus			- Eventually (with increased amplitude of stimulation) axial and then ipsilateral improvements noted	- System inadvertently deactivated 4 years postop, no deterioration in clinical symptoms
		- Bilateral intention tremor
		- Dystonic features			- Intention tremor and dystonia persisted
Hamasaki et al. [5], 2010	30 years	- Cervical dystonia that progressed to secondary generalized	52 years	GPi (bilateral)	- Dystonia and dystonic tremor improved over first weeks to months	- Continued improvements to 5 months with stabilization at last follow-up
		- Blepharospasm
		- Oromandibular grimacing			- Axial symptoms did not improve
		- Truncal bending and torsion
		- Dystonic tremor
		- Postural instability
Our patient - 1st implant	12–15 months	- Frequent stumbling	10 years	GPi (bilateral)	- Mild to moderate bilateral tremor reduction	- High impedance noted after 4 months prompting surgical exploration
		- Poor coordination with clumsy movements
		- Balance difficulty				- Opted to move intracranial leads to bilateral VIM in hopes of better response
		- Tremor (started at age 5)
Our patient - 2nd implant	Same	Same	11 years	VIM (bilateral)	- Resting tremor resolved with significant improvement in intention tremor	- Continued refinement in programming with continued substantial improvement in tremor control 12 months postoperatively

DBS, deep brain stimulation; VIM, ventral intermediate nucleus of the thalamus; GPi, globus pallidus interna.