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Case Reports
. 2020 Apr 22;12(4):e7786.
doi: 10.7759/cureus.7786.

The Unsuccessful Twiddler: A Case of Twiddler's Syndrome Without Deep Brain Stimulator Lead Breakage

Hammad Ghanchi  1 , Taha M Taka  2 , Jacob E Bernstein  1 , Samir Kashyap  1 , Ajay K Ananda  3
Affiliations
Case Reports

The Unsuccessful Twiddler: A Case of Twiddler's Syndrome Without Deep Brain Stimulator Lead Breakage

Hammad Ghanchi et al. Cureus. .

Abstract

The authors present the case of a 78-year-old right-handed female with a past medical history of Parkinson's disease, treated with implantation of a left-sided subthalamic nucleus St. Jude Medical Infinity® (Abbott Medical, Austin, TX) deep brain stimulator, who presented with lead-associated discomfort, or "bowstringing". Further investigation by chest X-ray revealed an extensive case of distal lead coiling. However, it was surprising that, despite the extensive coiling, the lead stayed intact without hardware failure as proven by patient remaining asymptomatic from her Parkinson's disease and intraoperative impedance testing demonstrating normal results. After revision surgery, the patient remained asymptomatic. Due to paucity of cases of this disease in the literature, specific predictive risk factors are not known, but certain patient characteristics may help take precautions.

Keywords: deep brain stimulator; parkinson's disease; twiddler's syndrome.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Chest X-ray demonstrating coiled leads on the left
Figure 2
Figure 2. Intraoperative view of the multiple coils noted once the battery was removed
See this image and copyright information in PMC

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