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Diplopia associated with loop routing in deep brain stimulation: illustrative case
BACKGROUND: Deep brain stimulation (DBS) is a powerful surgical option for drug-resistant movement disorders; however, electromagnetic interference (EMI) from external sources poses a potential risk for implanted electronics. OBSERVATIONS: A 61-year-old woman with Parkinson’s disease originally had...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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American Association of Neurological Surgeons
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9236169/ https://www.ncbi.nlm.nih.gov/pubmed/35854685 http://dx.doi.org/10.3171/CASE2031 |
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author | Miyagi, Yasushi Urasaki, Eiichirou |
author_facet | Miyagi, Yasushi Urasaki, Eiichirou |
author_sort | Miyagi, Yasushi |
collection | PubMed |
description | BACKGROUND: Deep brain stimulation (DBS) is a powerful surgical option for drug-resistant movement disorders; however, electromagnetic interference (EMI) from external sources poses a potential risk for implanted electronics. OBSERVATIONS: A 61-year-old woman with Parkinson’s disease originally had two implantable pulse generators (IPGs) for bilateral subthalamic DBS, which were then replaced with one dual-channel IPG routed in a loop. After the replacement surgery, with the same DBS programming as before the IPG replacement (bipolar setting for right, unipolar setting for left), the patient began to complain of transient paroxysmal diplopia. After multiple attempts to adjust the stimulation parameters, the diplopia was resolved by changing the left unipolar setting to a bipolar setting. At the authors’ institution, before the present case, four other patients had undergone IPG replacement with loop routing. None of these previous patients complained of diplopia; however, two of the four presented with diplopia in an experimental unipolar setting. LESSONS: Clinicians should be aware that loop-routed circuits may generate distortion of the stimulus field in DBS, even in the absence of external EMI sources. |
format | Online Article Text |
id | pubmed-9236169 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | American Association of Neurological Surgeons |
record_format | MEDLINE/PubMed |
spelling | pubmed-92361692022-07-18 Diplopia associated with loop routing in deep brain stimulation: illustrative case Miyagi, Yasushi Urasaki, Eiichirou J Neurosurg Case Lessons Clinical Article BACKGROUND: Deep brain stimulation (DBS) is a powerful surgical option for drug-resistant movement disorders; however, electromagnetic interference (EMI) from external sources poses a potential risk for implanted electronics. OBSERVATIONS: A 61-year-old woman with Parkinson’s disease originally had two implantable pulse generators (IPGs) for bilateral subthalamic DBS, which were then replaced with one dual-channel IPG routed in a loop. After the replacement surgery, with the same DBS programming as before the IPG replacement (bipolar setting for right, unipolar setting for left), the patient began to complain of transient paroxysmal diplopia. After multiple attempts to adjust the stimulation parameters, the diplopia was resolved by changing the left unipolar setting to a bipolar setting. At the authors’ institution, before the present case, four other patients had undergone IPG replacement with loop routing. None of these previous patients complained of diplopia; however, two of the four presented with diplopia in an experimental unipolar setting. LESSONS: Clinicians should be aware that loop-routed circuits may generate distortion of the stimulus field in DBS, even in the absence of external EMI sources. American Association of Neurological Surgeons 2021-01-04 /pmc/articles/PMC9236169/ /pubmed/35854685 http://dx.doi.org/10.3171/CASE2031 Text en © 2021 The authors https://creativecommons.org/licenses/by-nc-nd/4.0/CC BY-NC-ND 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) ). |
spellingShingle | Clinical Article Miyagi, Yasushi Urasaki, Eiichirou Diplopia associated with loop routing in deep brain stimulation: illustrative case |
title | Diplopia associated with loop routing in deep brain stimulation: illustrative case |
title_full | Diplopia associated with loop routing in deep brain stimulation: illustrative case |
title_fullStr | Diplopia associated with loop routing in deep brain stimulation: illustrative case |
title_full_unstemmed | Diplopia associated with loop routing in deep brain stimulation: illustrative case |
title_short | Diplopia associated with loop routing in deep brain stimulation: illustrative case |
title_sort | diplopia associated with loop routing in deep brain stimulation: illustrative case |
topic | Clinical Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9236169/ https://www.ncbi.nlm.nih.gov/pubmed/35854685 http://dx.doi.org/10.3171/CASE2031 |
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