Abstract
Twiddler syndrome occurs when a patient intentionally or unintentionally manipulates an implantable generator (usually a pacemaker) and dislodges the pacing leads, causing malfunction of the device. Though the syndrome has been described in patients with pacemakers, to our knowledge only one spontaneous case has been described in patients undergoing deep brain stimulation for movement disorders. We report the clinical cases of two patients with Parkinson’s disease who had subthalamic bilateral electrodes implanted and presented the twiddler syndrome 2 and 3 years after surgery. We analysed the possible mechanisms of this syndrome and note that twiddler syndrome should be suspected in patients undergoing deep brain stimulation and showing hardware dysfunction.
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Acknowledgements
The authors thank Mr. Romen Das Gupta for his assistance in the preparation of this paper.
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Comment
This is a short report of a rare hardware-related complication associated with DBS. I have previously contemplated the possibility of this complication, but I have never before heard of its occurrence. I found this report of two cases to be educational, entertaining and of some clinical interest. I believe that it is of certain interest to the readers of Acta Neurochirurgica.
Patric Blomstedt
Umea, Sweden
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Gelabert-Gonzalez, M., Relova-Quinteiro, JL. & Castro-García, A. “Twiddler syndrome” in two patients with deep brain stimulation. Acta Neurochir 152, 489–491 (2010). https://doi.org/10.1007/s00701-009-0366-6
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DOI: https://doi.org/10.1007/s00701-009-0366-6