Background/Objectives: Subthalamic nucleus deep brain stimulation (STN-DBS) is a standard treatment for motor complications in Parkinson’s disease (PD). Its impact on axial symptoms is still not fully understood. This study aimed to quantitatively evaluate the effect of frequency changes within the therapeutic window on postural control performances of individuals with PD who underwent bilateral STN-DBS. Methods: Postural control was assessed using Computerized Dynamic Posturography with randomized DBS frequency parameters, low (60 Hz), high (130 Hz), and very high (180 Hz), across six sensory organization test (SOT) conditions. Results: Twenty PD participants with a mean age of 61.2 ± 10.1 years were included. There were no differences in equilibrium scores of SOT conditions between 60, 130, and 180 Hz frequencies (p > 0.05), except the SOT6 score (p = 0.003), where 60 Hz showed better equilibrium performance in SOT6, indicating an advantage in postural control when visual cues are disturbed. Discussion: Low-frequency settings (60 Hz) in STN-DBS may benefit those who rely heavily on visual cues while ineffectively using somatosensory and vestibular inputs. Conclusions: A tailored approach to the DBS frequency setting could optimize postural stability and reduce fall risk in these patients. Future research is needed to explore these mechanisms to enhance therapeutic strategies.

Deep brain stimulation (DBS) is an effective treatment for movements disorders in patients with insufficient response to medication. However, since DBS is a device-assisted invasive surgical procedure, many complications may occur during the treatment of these patients. Some of these complications may have significant consequences, and sometimes a complete replacement of the DBS system is required, or, although rare, they may lead to life-threatening results when delayed. These complications can be prevented by early diagnosis and timely intervention. Therefore, managing the process with effective treatment from the very beginning is critical to minimize these complications.

Results: This case series study included 20 PD participants with STN-DBS, with a mean age of 61.2±10.1 years. There were no differences in equilibrium scores of SOT conditions between 60, 130, and 180 Hz frequencies (p> 0.05), except the SOT6 score (p= 0.003), where 60 Hz showed better equilibrium performance in SOT6, indicating an advantage in postural control when visual and somatosensory cues are disturbed, and vestibular cues are not.

Epidural steroid enjeksiyonları, özellikle lomber disk hernisi ve radiküler ağrı durumlarında, ağrı tedavisinde sıkça kullanılmaktadır. Genellikle güvenli olmalarına rağmen, nadir komplikasyonlar zaman zaman ortaya çıkabilmektedir. Kronik radiküler ağrısı olan ve konservatif tedaviye yanıt vermeyen 43 yaşındaki erkek hasta, L4-L5 ve L5-S1 seviyelerine dorsal kök ganglion pulsed radyofrekans (DRG-PRF) ve ardından transforaminal steroid enjeksiyonu (TFESI) ile tedavi edilmiştir. İşlemden yaklaşık 20 saat sonra başlayan ve 48 saat süren, uykusunu bölecek şiddette inatçı hıçkırık gelişmiştir. Yapılan takip değerlendirmelerinde nörolojik veya sistemik herhangi bir patoloji saptanmamış; semptomlar medikal müdahale olmadan kendiliğinden gerilemiştir. Epidural enjeksiyon sonrası hıçkırık nadiren rapor edilmekle birlikte, göz ardı edilen bir komplikasyon olabilir. Klinik pratikte, kortikosteroidlere bağlı santral etkiler, epidural basınç değişimleri ya da otonom sinir sistemi dengesizlikleri olası mekanizmalar olarak değerlendirilmelidir. Bu olgu, bu tür atipik komplikasyonlara yönelik farkındalığın artırılması gerektiğini vurgulamaktadır.