Accessory nerve injury after deep brain stimulation surgery in a Parkinson’s disease patient

•Accessory nerve injury after DBS is an complication reported in a few studies.•Stimulation-related complications of DBS are highly dependent on the brain target and lead location.•The spinal accessory nerve (SAN) is susceptible to iatrogenic injury.•This type of complication highlights the importance of examining accessory nerve after the procedure. DBS is an established form of surgical therapy for Parkinson's disease and is also used for other pathologies, such as dystonia and essential tremor. There are few articles in the literature discussing exclusively about surgical complications. In fact, most papers describe surgical-related complications such seizures, device infection, hemorrhage and permanent deficit. However, less usual complications can also occur, as in the case described below, of an injury to the accessory nerve after the DBS procedure. We describe a case of a 56-year-old woman with PD who underwent to STN DBS, presented hypotrophy and weakness of the right trapezius after the surgery. Electroneuromyography (ENMG) suggested partial right spinal accessory injury. Patient recovery spontaneously 5 months after surgery. While DBS promises dramatic improvement in select PD symptoms, it can have disappointing or even serious adverse results. This paper ratifies the need of screening of accessory nerve injury for early rehabilitation.