Related Experiment Video
Updated: Jun 23, 2026
14:14
Targeting Neuronal Fiber Tracts for Deep Brain Stimulation Therapy Using Interactive, Patient-Specific Models
Published on: August 12, 2018
"Twiddler syndrome" in two patients with deep brain stimulation.
Miguel Gelabert-Gonzalez1, José-Luis Relova-Quinteiro, Alfonso Castro-García
1Department of Surgery, University of Santiago de Compostela, Santiago de Compostela, Spain. miguel.gelabert@usc.es
Acta Neurochirurgica
|May 14, 2009
Summary
Twiddler syndrome, a device malfunction caused by lead dislodgement, is reported in two Parkinson's disease patients with deep brain stimulation. This condition should be suspected in patients with movement disorders experiencing hardware issues.
Area of Science:
- Neurosurgery
- Neurology
- Biomedical Engineering
Background:
- Twiddler syndrome is a known complication of pacemakers, resulting from generator manipulation and lead dislodgement.
- Deep brain stimulation (DBS) is an established treatment for movement disorders like Parkinson's disease.
- While rare, Twiddler syndrome has been documented in DBS, with only one prior spontaneous case reported.
Observation:
- Two patients with Parkinson's disease who underwent bilateral subthalamic nucleus DBS presented with Twiddler syndrome.
- The syndrome manifested 2 and 3 years post-implantation, suggesting a delayed onset.
- Clinical presentation involved hardware dysfunction attributed to lead dislodgement.
Findings:
- This report details two new cases of Twiddler syndrome in DBS patients, significantly increasing the known incidence.
- Analysis suggests potential mechanisms for lead dislodgement in the context of DBS hardware.
- The findings highlight the importance of considering Twiddler syndrome in DBS patients presenting with device malfunction.
Implications:
- Clinicians should maintain a high index of suspicion for Twiddler syndrome in DBS patients exhibiting hardware-related issues.
- Early diagnosis and management are crucial to restore device function and therapeutic benefit.
- Further research into preventative strategies and risk factors for Twiddler syndrome in DBS is warranted.
