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Manipulating an internal pulse generator until twiddler’s syndrome in a patient treated with deep brain stimulation for obsessive-compulsive disorder

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Abstract

Background: Twiddler’s syndrome consists of rotation or manipulation of an implantable pulse generator (IPG) in its subcutaneous pocket by a patient, thus causing hardware malfunction. Methods: This syndrome is being reported more frequently in patients treated with deep brain stimulation (DBS). Results: We report the case of a woman who had received bed nucleus of stria terminalis (BNST) electrodes for obsessive-compulsive disorder (OCD) and developed twiddler’s syndrome a few months after surgery, causing hardware malfunction due to obsessive manipulation of the IPG. Conclusion: The patient did not have compulsions related to touching objects at admission, thus making it difficult to foresee and prevent TS.

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Abbreviations

DBS:

Deep brain stimulation

OCD:

Obsessive-compulsive disorder

TS:

Twiddler’s syndrome

IPG:

Implantable pulse generator

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Contributors

AF and GM contributed to the conception and design of the article, data acquisition, analysis and interpretation. All the authors were involved in critically drafting/revising the article for important intellectual content. Finally, they all gave final approval of the version to be published.

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Authors and Affiliations

  1. Department of Neurosurgery, Fondazione IRCCS Istituto Nazionale Neurologico Carlo Besta, Via Giovanni Celoria 11, 20133, Milan, Italy

    Andrea Franzini & Giuseppe Messina

  2. Department of Health Sciences, Università Degli Studi di Milano, Milan, Italy

    Rebecca Ranieri & Orsola Gambini

  3. Department of Mental Health, San Paolo Hospital, Milan, Italy

    Rebecca Ranieri & Orsola Gambini

Authors
  1. Andrea Franzini
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  2. Rebecca Ranieri
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  3. Orsola Gambini
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  4. Giuseppe Messina
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Corresponding author

Correspondence to Andrea Franzini.

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Franzini, A., Ranieri, R., Gambini, O. et al. Manipulating an internal pulse generator until twiddler’s syndrome in a patient treated with deep brain stimulation for obsessive-compulsive disorder. Acta Neurochir 160, 389–392 (2018). https://doi.org/10.1007/s00701-017-3412-9

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  • DOI: https://doi.org/10.1007/s00701-017-3412-9

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