Transcranial Direct Current Stimulation (tDCS) in a Patient with PRES and Bipolar Depression

Abstract

Transcranial direct current stimulation (tDCS) is a non-invasive tool for brain stimulation and has proven efficacy in depressive disorders. Here, we report the case of a patient with recurrent bipolar depressive disorder and neurologic complications due to posterior reversible encephalopathy syndrome (PRES) due to parathyroid adenoma. During a long-term hospital stay, multiple drug regimens did not resolve depressive symptoms. Finally, an add-on therapy with tDCS brought improvement of symptoms. This case highlights the feasibility of tDCS in treatment-resistant depression and concomitant neurologic disorder.

Zusammenfassung

Transkranielle Gleichstromstimulation (tDCS) ist ein nicht-invasives Hirnstimulationsverfahren, das zur Behandlung der Depression eingesetzt wird. Wir berichten über eine Patientin mit rezidivierenden depressiven Episoden im Rahmen einer bipolar-affektiven Störung und neurologischer Komplikationen bei posteriorem reversiblem Enzephalopathie-Syndrom (PRES) aufgrund eines Nebenschilddrüsenadenoms. Während eines längerfristigen Krankenhausaufenthalts wurden verschiedene psychopharmakologische Therapieversuche erfolglos durchgeführt. Schließlich wurde eine Gleichstromstimulation zusätzlich zur Medikation angewendet und brachte eine Verbesserung der Symptome. Dieser Fall zeigt die problemlose Anwendbarkeit der tDCS bei therapieresistenter Depression und begleitender neurologischer Erkrankung.

Key words

parathyroid adenoma - status epilepticus - Posterior Reversible Encephalopathy Syndrome

Schlüsselwörter

Nebenschilddrüsenadenom - Status epilepticus - Posteriores Reversibles Enzephalopathie-Syndrom

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