Dislodgment of pacemaker electrode simulating focal motor seizure

Area of Science:

• Neurology
• Cardiology
• Medical Device Technology

Background:

• Pacemakers are crucial for managing cardiac arrhythmias.
• Electrode lead integrity is vital for device function and patient safety.

Observation:

• A patient presented with unexplained repetitive right leg twitching.
• The symptoms mimicked focal motor seizures, leading to inappropriate antiepileptic drug treatment.

Findings:

• Diagnostic imaging (roentgenography) revealed the pacemaker electrode had dislocated from its intended position.
• The leg twitching was directly attributed to the malpositioned electrode stimulating motor pathways.

Implications:

• This case underscores the need to consider device malfunction in atypical neurological presentations.
• Accurate diagnosis through imaging is essential for effective treatment of pacemaker-related complications.
• Highlights the importance of interdisciplinary collaboration between cardiology and neurology.