Cutaneous herpes zoster and implantable pulse generator

Area of Science:

• Neurosurgery
• Neurology
• Infectious Diseases

Background:

• Subthalamic nucleus deep brain stimulation (STN-DBS) is an established treatment for advanced Parkinson's disease.
• Adverse events from STN-DBS are typically reported in the immediate or short-term postoperative period.
• Delayed complications, such as infections, are less common but significant.

Purpose of the Study:

• To report a rare case of delayed herpes zoster (HZ) infection occurring two years after STN-DBS lead implantation.
• To highlight the importance of recognizing HZ as a potential complication of implanted neurostimulation devices.
• To emphasize the need for prompt diagnosis and management to prevent chronic pain.

Main Methods:

• A case study of a 65-year-old male patient who underwent STN-DBS for Parkinson's disease.
• Documentation of the onset of herpes zoster (shingles) at the pulse generator site, two years post-implantation.
• Review of patient's response to antiviral therapy.

Main Results:

• The patient developed herpes zoster (HZ) at the subcutaneous pulse generator site, two years after the initial deep brain stimulation surgery.
• The patient experienced an excellent recovery from HZ lesions and associated pain following antiviral treatment.
• This case illustrates a delayed, unusual complication of neurostimulation surgery.

Conclusions:

• Herpes zoster can occur as a late complication following deep brain stimulation surgery for Parkinson's disease.
• Prompt diagnosis and appropriate antiviral therapy are essential for managing HZ and preventing long-term sequelae.
• Clinicians should consider HZ in the differential diagnosis of new-onset skin lesions or pain at the implant site in patients with neurostimulation devices.