Position-Dependent Dysfunction of Deep Brain Stimulation in Tourette Syndrome: Diagnostic Clues

Background: Detection of defective deep brain stimulation (DBS) contacts/electrodes is sometimes challenging. Case Report: We report a patient with Tourette syndrome (TS), who presented with abrupt tic increase and mild generalized headache 9 years after DBS implantation. On the suspicion of a hardw...

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Main Authors: Marc E. Wolf, Olaf Majewski, Kirsten R. Müller-Vahl, Christian Blahak, Dirk-Michael Schulte, Joachim K. Krauss
Format: Article
Language:English
Published: Ubiquity Press 2019-10-01
Series:Tremor and Other Hyperkinetic Movements
Subjects:
Online Access:https://tremorjournal.org/index.php/tremor/article/view/713/2476
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spelling doaj-96c101fd1be44ab3bd5de0f6f8ebedbd2021-04-02T13:31:54ZengUbiquity PressTremor and Other Hyperkinetic Movements2160-82882019-10-01901310.7916/tohm.v0.713713Position-Dependent Dysfunction of Deep Brain Stimulation in Tourette Syndrome: Diagnostic CluesMarc E. Wolf0Olaf Majewski1Kirsten R. Müller-Vahl2Christian Blahak3Dirk-Michael Schulte4Joachim K. Krauss5Department of Neurology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, DEDepartment of Neurosurgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, DEClinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, DEDepartment of Neurology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, DEDepartment of Neurosurgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, DEDepartment of Neurosurgery, Hannover Medical School, Hannover, DEBackground: Detection of defective deep brain stimulation (DBS) contacts/electrodes is sometimes challenging. Case Report: We report a patient with Tourette syndrome (TS), who presented with abrupt tic increase and mild generalized headache 9 years after DBS implantation. On the suspicion of a hardware defect, a fracture of the DBS electrode and extension lead was ruled out by radiography and standard implantable pulse generator readouts. Further investigation revealed position-dependent modifiable therapeutic impedances, suggesting an impaired contact of the extension lead/adaptor. After replacement normal impedances were recorded, and the patient fully recovered. Discussion: In DBS dysfunction with inconspicuous hardware check, position-dependent defects might be suspected.https://tremorjournal.org/index.php/tremor/article/view/713/2476Deep brain stimulationhardware complicationsimpedanceTourette syndrome
collection DOAJ
language English
format Article
sources DOAJ
author Marc E. Wolf
Olaf Majewski
Kirsten R. Müller-Vahl
Christian Blahak
Dirk-Michael Schulte
Joachim K. Krauss
spellingShingle Marc E. Wolf
Olaf Majewski
Kirsten R. Müller-Vahl
Christian Blahak
Dirk-Michael Schulte
Joachim K. Krauss
Position-Dependent Dysfunction of Deep Brain Stimulation in Tourette Syndrome: Diagnostic Clues
Tremor and Other Hyperkinetic Movements
Deep brain stimulation
hardware complications
impedance
Tourette syndrome
author_facet Marc E. Wolf
Olaf Majewski
Kirsten R. Müller-Vahl
Christian Blahak
Dirk-Michael Schulte
Joachim K. Krauss
author_sort Marc E. Wolf
title Position-Dependent Dysfunction of Deep Brain Stimulation in Tourette Syndrome: Diagnostic Clues
title_short Position-Dependent Dysfunction of Deep Brain Stimulation in Tourette Syndrome: Diagnostic Clues
title_full Position-Dependent Dysfunction of Deep Brain Stimulation in Tourette Syndrome: Diagnostic Clues
title_fullStr Position-Dependent Dysfunction of Deep Brain Stimulation in Tourette Syndrome: Diagnostic Clues
title_full_unstemmed Position-Dependent Dysfunction of Deep Brain Stimulation in Tourette Syndrome: Diagnostic Clues
title_sort position-dependent dysfunction of deep brain stimulation in tourette syndrome: diagnostic clues
publisher Ubiquity Press
series Tremor and Other Hyperkinetic Movements
issn 2160-8288
publishDate 2019-10-01
description Background: Detection of defective deep brain stimulation (DBS) contacts/electrodes is sometimes challenging. Case Report: We report a patient with Tourette syndrome (TS), who presented with abrupt tic increase and mild generalized headache 9 years after DBS implantation. On the suspicion of a hardware defect, a fracture of the DBS electrode and extension lead was ruled out by radiography and standard implantable pulse generator readouts. Further investigation revealed position-dependent modifiable therapeutic impedances, suggesting an impaired contact of the extension lead/adaptor. After replacement normal impedances were recorded, and the patient fully recovered. Discussion: In DBS dysfunction with inconspicuous hardware check, position-dependent defects might be suspected.
topic Deep brain stimulation
hardware complications
impedance
Tourette syndrome
url https://tremorjournal.org/index.php/tremor/article/view/713/2476
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