Twiddler's syndrome in a patient with epilepsy treated with deep brain stimulation

Epilepsia
David L PennAshwini D Sharan

Abstract

Twiddler's syndrome is the conscious or unconscious manipulation of implantable pulse generators (IPGs) or associated wire systems by the patient. Most commonly, this complication has been documented in patients with cardiac pacemakers, but there are reported cases in patients with deep brain stimulators. Twisting of stimulator systems results in dislodgement or damage to leads and loss of stimulation to the desired target. The present case illustrates a rare complication that may have serious consequences in patients with deep brain stimulators. A 21 year-old woman presented with recurrence of seizures from failure of her deep brain stimulator targeting the anterior nuclei of the thalamus to control refractory epilepsy, 6 months after it was implanted. Radiographic imaging revealed that the IPG had been twisted upon itself causing coiling and looping of extension wires. The patient denied any conscious manipulation of the system, which was subsequently surgically revised. Surgical revision achieved the desired stimulation and effects. On 4-month follow-up the deep brain stimulator remained stable and untwisted; however, it was subsequently removed in the fourth month because of infection at the extension site. In conclusion, t...Continue Reading

References

Apr 25, 2003·The New England Journal of Medicine·William J NicholsonPeter Tilkemeier
Jan 6, 2005·The Journal of Thoracic and Cardiovascular Surgery·F BrackeA Meijer
Jun 5, 2007·Surgical Neurology·Gregory Geissinger, John H Neal
Sep 16, 2008·Stereotactic and Functional Neurosurgery·Zvi Israel, Alexander Spivak
Mar 11, 2009·Pacing and Clinical Electrophysiology : PACE·Nematollah JaafariWissam El Hage
May 14, 2009·Acta neurochirurgica·Miguel Gelabert-GonzalezAlfonso Castro-García
Jul 14, 2009·Southern Medical Journal·Gurpreet Singh SidhuMichel Reinig

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Citations

Nov 19, 2015·Acta neurochirurgica·Rafid Al-MahfoudhJibril Osman Farah
Sep 6, 2012·Neuromodulation : Journal of the International Neuromodulation Society·Chengyuan Wu, Ashwini D Sharan
Jun 4, 2016·Pharmacological Reviews·Martin J BrodieBernhard J Steinhoff

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