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DBS and diathermy interaction induces severe CNS damage
J G Nutt1, V C Anderson, J H Peacock
1Department of Neurology, Oregon Health Sciences University, Portland 97201-3098, USA. nuttj@ohsu.edu
Neurology
|May 29, 2001
Summary
Radiofrequency diathermy targeting the maxilla caused permanent brain lesions and a vegetative state in a Parkinson's disease patient with deep brain stimulation electrodes. This highlights risks associated with diathermy in patients with implanted neurostimulation devices.
Area of Science:
- Neurosurgery
- Neurology
- Medical Physics
Background:
- Deep brain stimulation (DBS) is a therapeutic option for Parkinson's disease (PD).
- Subthalamic nucleus (STN) DBS involves implanted electrodes for neuromodulation.
- Radiofrequency (RF) diathermy is a therapeutic modality used in physical medicine.
Observation:
- A patient with PD and implanted STN DBS electrodes underwent pulse-modulated RF diathermy treatment directed at the maxilla.
- The diathermy application was intended for therapeutic purposes unrelated to the DBS system.
Findings:
- The RF diathermy treatment resulted in permanent lesions in the patient's diencephalon and brainstem.
- The patient's neurological status deteriorated, leading to a persistent vegetative state.
Implications:
- This case underscores the critical risk of diathermy-induced tissue damage in patients with implanted neurostimulation hardware.
- Careful consideration and potentially contraindication of diathermy are warranted in patients with DBS systems.
- Further research is needed to understand the interaction between RF energy and implanted neurostimulation devices to prevent adverse events.