Abstract
<strong>Background:</strong> Detection of defective deep brain stimulation (DBS) contacts/electrodes is sometimes challenging. <strong>Case Report:</strong> 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. <strong>Discussion:</strong> In DBS dysfunction with inconspicuous hardware check, position-dependent defects might be suspected.
Highlights
Case ReportsPosition-Dependent Dysfunction of Deep Brain Stimulation in Tourette Syndrome: Diagnostic Clues
Deep brain stimulation (DBS) in patients with Tourette syndrome (TS) results in a tic reduction of about 40%.1 Most often used targets are the globus pallidus internus (GPi) and thalamic nuclei.[1]
Case report We report on a male patient with TS, who suffered from severe motor and vocal tics as well as obsessive-compulsive disorder and underwent bilateral deep brain stimulation (DBS) electrode implantation using computed tomography (CT)-stereotactic
Summary
Position-Dependent Dysfunction of Deep Brain Stimulation in Tourette Syndrome: Diagnostic Clues. Wolf1,2*, Olaf Majewski[3], Kirsten R. Müller-Vahl[4], Christian Blahak[1,5], Dirk-Michael Schulte3 & Joachim K. Krauss6 1Department of Neurology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, DE, 2Department of Neurology, Neurocentre, Klinikum Stuttgart, Stuttgart, DE, 3Department of Neurosurgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, DE, 4Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, DE, 5Department of Neurology, Ortenau Klinikum Lahr-Ettenheim, Lahr, DE, 6Department of Neurosurgery, Hannover Medical School, Hannover, DE
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