Twiddler's Syndrome

Area of Science:

• Medical Devices
• Neurosurgery
• Radiology

Background:

• Twiddler's syndrome is a rare but severe complication following the implantation of neurostimulators or pacemakers.
• It arises from the mechanical manipulation of the implanted generator within its subcutaneous pocket.

Purpose of the Study:

• To highlight the etiology and radiographic findings of Twiddler's syndrome.
• To emphasize the importance of recognizing this complication for appropriate patient management.

Main Methods:

• Review of clinical cases and radiographic findings associated with Twiddler's syndrome.
• Analysis of the mechanism of generator migration and electrode disruption.

Main Results:

• Twiddler's syndrome involves the twisting of the generator, leading to lead dislodgement or malfunction.
• Radiographic examination is crucial for diagnosing the dislodged electrodes and abnormal generator position.

Conclusions:

• Twiddler's syndrome is a preventable complication that requires awareness among implanting physicians.
• Early diagnosis via X-ray is essential for timely intervention and to prevent further complications.