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Position-Dependent Dysfunction of Deep Brain Stimulation in Tourette Syndrome: Diagnostic Clues
Marc E Wolf1,2, Olaf Majewski3, Kirsten R Müller-Vahl4
1Department of Neurology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, DE.
Background:
Detection of defective deep brain stimulation (DBS) contacts/electrodes is sometimes challenging.
Case Report:
We report a patient with Tourette syndrome (TS), who presented with abrupt tic increase and mild generalized headache 9 years after DBS implantation. On the suspicion of a hardware defect, a fracture of the DBS electrode and extension lead was ruled out by radiography and standard implantable pulse generator readouts. Further investigation revealed position-dependent modifiable therapeutic impedances, suggesting an impaired contact of the extension lead/adaptor. After replacement normal impedances were recorded, and the patient fully recovered.
Discussion:
In DBS dysfunction with inconspicuous hardware check, position-dependent defects might be suspected.
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